Pereira José Antonio, Montcusí Blanca, López-Cano Manuel, Hernández-Granados Pilar, Fresno de Prado Laura
Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, España; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España.
Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, España.
Cir Esp (Engl Ed). 2018 Aug-Sep;96(7):436-442. doi: 10.1016/j.ciresp.2018.03.008. Epub 2018 May 10.
Registries are powerful tools for identifying factors predicting bad results. Our objective was to analyse data from the Spanish Registry of Incisional Hernia (EVEREG) to detect risk situations for the development of complications and recurrences.
We have analysed data of the cohort of hernias registered during the period from July 2012 to June 2014. We have compared the data between complicated and non-complicated patients in the short and long term follow-up. Data compared were: patient demographics, comorbid condition, hernia defect characteristics and surgical technique to determine which of them may be predictors of poor outcomes.
During the period of study, we collected data from 1,336 hernias (43.7% males; 56.3% females) with a mean age of 63.6 years (SD 12.4) and BMI of 30.4 (SD 5.4). In the multivariate analysis, factors associated with complications were: age >70 years, previous neoplasm, diameter greater than 10cm, previous repair and bowel resection. Factors related with recurrences were: parastomal hernia, previous repair, emergency repair, postoperative complications and reoperation. A separation of components was the only protective factor for this type of analysis (OR 0.438; CI 0.27-0.71; p=0.0001).
Risk factors for the development of complications and recurrences must be considered for promoting preoperative patient prehabilitation, planning the surgical technique and referring patients to specialized abdominal wall units.
登记系统是识别预测不良结果因素的有力工具。我们的目的是分析西班牙切口疝登记系统（EVEREG）的数据，以检测并发症和复发发生的风险情况。
我们分析了2012年7月至2014年6月期间登记的疝队列数据。我们比较了短期和长期随访中复杂和非复杂患者的数据。比较的数据包括：患者人口统计学、合并症、疝缺损特征和手术技术，以确定哪些因素可能是不良结果的预测因素。
在研究期间，我们收集了1336例疝的数据（男性占43.7%；女性占56.3%），平均年龄为63.6岁（标准差12.4），体重指数为30.4（标准差5.4）。在多变量分析中，与并发症相关的因素有：年龄>70岁、既往有肿瘤、直径大于10cm、既往有修补术和肠切除术。与复发相关的因素有：造口旁疝、既往有修补术、急诊修补、术后并发症和再次手术。成分分离是这类分析的唯一保护因素（比值比0.438；可信区间0.27 - 0.71；p = 0.0001）。
为了促进术前患者的预康复、规划手术技术以及将患者转诊至专业腹壁治疗单位，必须考虑并发症和复发发生的危险因素。
