Kingsnorth's modified score as predictor of complications in open inguinal hernia repair

Bravo-Salva, Alejandro; Salvá Puigserver, Margarita; Téllez-Marqués, Clara; Pérez-Guitart, Marc; González-Martín, Alba; Sancho Insenser, Juan; Pera Román, Miguel; Pereira Rodríguez, José Antonio

doi:http://dx.doi.org/10.1007/s13304-022-01341-2

Kingsnorth's modified score as predictor of complications in open inguinal hernia repair

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Bravo-Salva A, Salvá Puigserver M, Téllez-Marqués C, Pérez-Guitart M, González-Martín A, Sancho-Insenser JJ, Pera-Roman M, Pereira-Rodríguez JA. Kingsnorth's modified score as predictor of complications in open inguinal hernia repair. Updates Surg. 2022 Dec;74(6):1985-93. DOI: 10.1007/s13304-022-01341-2

Abstract

Purpose: This study aims to analyse the postoperative complications (30 days) on unilateral primary inguinal hernia repair and prove their correlation with the preoperative modified scoring system of Kingsnorth (KN). Methods: Prospective study design collecting data from patients who underwent surgery for unilateral primary inguinal hernia in a University Hospital. The data were collected in the National Inguinal Hernia Registry (EVEREG). A statistical analysis to assess the association between the presence of postoperative complications and the preoperative and intraoperative variables was performed. The patients were classified depending on their KN score. Surgical complications and their relationship with the classification were specifically analysed. Study design was performed following STROBE statements. Results: The sample included 403 patients who met the inclusion criteria from which 62 (15.3%) subjects presented postoperative complications. The variables that presented a statistically significant relationship with the appearance of complications were a KN score of 5-8 (OR 2.7; 95% CI 1.07-4.82; P = 0.03) and the involvement of a member of the abdominal wall surgery unit in the procedure (OR 0.28; 95% CI 0.08-0.92; P = 0.03). The KN score correlated with a longer duration of surgery (Pearson's correlation 0.291; P < 0.0001). Conclusion: The KN classification can predict the onset of surgical wound complications on patients who undergo a primary unilateral inguinal hernia surgery. A KN score of 5-8 has a higher probability of wound complications. When surgery is performed by the abdominal wall surgery unit, the chances of postoperative complications decrease.