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Revista Cubana de Medicina Militar

Print version ISSN 0138-6557On-line version ISSN 1561-3046

Abstract

LOMBARDO VAILLANT, Tomás Ariel; SOLER MOREJON, Caridad; LOMBARDO VAILLAN, Juvenal  and  CASAMAYOR LAIME, Zuleika. Application of the predictive index of abdominal reintervention in diagnosis of intraabdominal infectious complications . Rev Cub Med Mil [online]. 2009, vol.38, n.1. ISSN 0138-6557.

INTRODUCTION: Intraabdominal infectious complications are conditions that worsen the prognosis of patients undergoing laparotomy and even today, they are difficult to be diagnosed and efficiently treated. OBJECTIVE: To evaluate the predictive index of abdominal reintervention in laparotomized patients. METHODS: A prospective, observational cross-sectional study was performed on 200 laparotomized patients at "Dr Luis Díaz Soto" Higher Institute of Military Medicine from January 1995 to August 1996. The patients were divided into two groups according to their health status at discharge and the criteria for reintervention. The variable association was determined by X² test with 95 % CI, and cross product ratio for effect measurement. The diagnostic quality was based on sensitivity, specificity and positive and negative predictive values. RESULTS: The highest number of reinterventions was found in the over 50 years-old age group. There was close association between abdominal reintervention predictive index scores higher than 11 and reintervention (X²= 134.3194; p= 0.000). All abdominal reintervention predictive index variables (except for altered consciousness) were highly associated with the decision to perform reintervention. The quality of abdominal reintervention predictive index was proved since sensitivity was 97.67 %, CI [96.48-98,98.86], specificity was 80.89, CI [80.54-81.25] and validity index reached 84.50 %, CI [84.22-84.78]. CONCLUSIONS: The abdominal reintervention predictive index is an excellent, valid and easy to use tool for the surgeon in diagnosing intraabdominal infectious complication.

Keywords : ARPI; intraabdominal infectious complication; relaparotomy, "on demand"; diagnostic quality..

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