ArticleLangenbeck's archives of surgery2025
External validation of the ACS NSQIP surgical risk calculator for the prediction of surgical site infection (SSI) and its association with the postoperative occurrence of incisional hernia (IH) in midline laparotomy patients.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Development and Internal Validation of a Simplified Clinical Risk Score for Systemic Complications After Spine Surgery Using a Nationwide Japanese Registry: JOANR/JSSR-DB.Spine surgery and related research · 2026Article
- External validation of the IHXGboost-P model to predict incisional hernia after midline laparotomy.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Systematic Review and Meta-Analysis of the Prevalence and Risk Factors Associated With the Occurrence of Incisional Hernia in Patients Undergoing Midline Laparotomy.Journal of abdominal wall surgery : JAWS · 2026Review
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Authors and funding
10 authors.
Funding
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Abstract
purposeIncisional hernia (IH) is a common complication following midline laparotomy, with an incidence of 12.8% at 23.8 months of follow-up. Surgical site infection (SSI) is a significant risk factor for IH. The ACS NSQIP Surgical Risk Calculator is a widely used tool for predicting postoperative complications, including SSI. This study aims to externally validate this calculator in a population of patients undergoing midline laparotomy.
methodsA retrospective longitudinal study was conducted on 1083 patients who underwent midline laparotomy between January 2015 and November 2022. The ability of the ACS NSQIP calculator to predict SSI and its association with the occurrence of IH was evaluated.
resultsThe incidence of SSI was 13.21%. The ACS NSQIP calculator demonstrated good discriminative ability (AUC 0.88) and calibration (Brier score 0.072) for predicting SSI. An optimal cutoff point of 6.6 was identified, with a sensitivity of 78% and specificity of 92%. The presence of SSI increased the risk of IH by a factor of 6 (OR 5.9, 95% CI 3.4-10.3).
conclusionsThe ACS NSQIP Surgical Risk Calculator is a valid tool for predicting SSI in patients undergoing midline laparotomy, with good discriminative ability and calibration. SSI is a significant risk factor for the occurrence of IH, suggesting that including this variable in IH prediction scales could improve their accuracy.
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