Predictive risk score for infection after inguinal hernia repair

Background Identification of subgroups of patients at high and low risk for global infectious complications (GIC) after inguinal hernia repair without mesh. Methods A database of 1254 patients who underwent inguinal hernia repair without mesh, issued from 3 prospective multicenter randomized trials, has been established (group A). After multivariate analysis, a score for GIC was calculated and tested using data from a similar prospective randomized multicenter study (group B). Results A risk score for GIC was constructed: −4.7 + (0.95 × age ≥75 years) + (1.1 obesity) + (2.1 × urinary catheter). In case of score less than −4.2 (low-risk group), the GIC rate was 2.7%; therefore, in case of score more than −4.2 (high-risk score), the GIC rate was 14.3% (P< .001). In the low-risk group, the administration of antibiotic prophylaxis did not reduce the infectious complication rate, while in high-risk group the administration of antibiotic prophylaxis significantly reduced the rates of surgical site infection, GIC, and urinary infection by 72%, 67%, and 76.8%, respectively. Conclusions This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients.