Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study
| Autor: | Wenfeng Xiao, Xuewu Jiang, Shouxing Duan, Wenhui Ou, Xinquan Xie, Maxian Fu, Kaihong Chen, Lian Zheng, Jianhong Li, Xuan Zhang, Shuhua Ma |
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| Rok vydání: | 2021 |
| Předmět: |
Abdomen wound dehiscence (AWD)
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Dehiscence 03 medical and health sciences Hypoproteinemia Postoperative Complications 0302 clinical medicine Risk Factors Laparotomy Abdomen Surgical Wound Dehiscence medicine Humans 030212 general & internal medicine Hypoalbuminemia Retrospective Studies Wound dehiscence business.industry Infant Newborn incision contamination Retrospective cohort study General Medicine Nomogram medicine.disease neonates Surgery business Research Article Abdominal surgery |
| Zdroj: | Annals of Medicine article-version (VoR) Version of Record |
| ISSN: | 1365-2060 0785-3890 |
| DOI: | 10.1080/07853890.2021.1938661 |
| Popis: | Background Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, and neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD and construct a predictive model. Methods The clinical data of 453 cases that underwent neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were identified. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anaemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD. Results The incidence of neonatal AWD was 6.0% (27/453), among which partial wound dehiscence accounted for 4.9% (22/453) and complete wound dehiscence accounted for 1.1% (5/453). Hypoproteinemia and incision type were the independent risk factors for neonatal AWD, and weight at admission was a protective factor for AWD in the multivariate models. All these factors were incorporated to construct a nomogram, and a calibration curve was plotted. The result indicated that the actual risk was close to the predicted risk when the predicted risk rate was greater than about 35%. Conclusions Neonatal AWD is closely related to hypoproteinemia and incision contamination. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery.Key messagesNeonatal abdominal wound dehiscence (AWD) has a serious consequence and the incidence of neonatal AWD was about 6.0% and the complete AWD morbidity is 1.1%.Hypoproteinemia and incision type were the independent risk factors for neonatal AWD.Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery. |
| Databáze: | OpenAIRE |
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