The efficacy of risk scores for predicting abdominal wound dehiscence : a case-controlled validation study

BACKGROUND: The medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence. These risk indices were validated by the authors on the populations studied. However, whether these scoring systems can accurately predict, abdominal wound dehiscence in other populations remains unclear. METHODS: A retrospective analysis was performed using the medical records of patients treated at a tertiary-care teaching hospital between 2008 and 2011. Patients that underwent laparotomy procedures complicated by the development of postoperative abdominal wound dehiscence were included into the study. For each of the cases, three controls were selected. RESULTS: Among the 1,879 patients undergoing intra-abdominal, 56 patients developed wound dehiscence and 168 patients included in the control group. Calculation of risk scores for all patients, revealed significantly higher scores in the abdominal wound dehiscence group (p < 0.001). The median score was 24 (range: 3–46) and 4.95 (range: 2.2-7.8) vs.10 (range:-3-45) and 3.1 (range:0.4-6.9), for the Veterans Affairs Medical Center (VAMC) and Rotterdam abdominal wound dehiscence risk score in the dehiscence and control groups, respectively. The area under the curve, on the ROC plot, was 0.84 and 0.76; this confirmed a good and moderate predictive value for the risk scores. The fit of the model was good in both cases, as shown by the Hosmer and Lemeshow test. CONCLUSIONS: Both the VAMC and Rotterdam scores can be used for the prediction of abdominal wound dehiscence. However, the VAMC prognostic score had better calibration and discriminative power when applied to the population in this study and taking into consideration our method of control selection

The efficacy of risk scores for predicting abdominal wound dehiscence: a case-controlled validation study

BACKGROUND: The medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence. These risk indices were validated by the authors on the populations studied. However, whether these scoring systems can accurately predict, abdominal wound dehiscence in other populations remains unclear. METHODS: A retrospective analysis was performed using the medical records of patients treated at a tertiary-care teaching hospital between 2008 and 2011. Patients that underwent laparotomy procedures complicated by the development of postoperative abdominal wound dehiscence were included into the study. For each of the cases, three controls were selected. RESULTS: Among the 1,879 patients undergoing intra-abdominal, 56 patients developed wound dehiscence and 168 patients included in the control group. Calculation of risk scores for all patients, revealed significantly higher scores in the abdominal wound dehiscence group (p < 0.001). The median score was 24 (range: 3–46) and 4.95 (range: 2.2-7.8) vs.10 (range:-3-45) and 3.1 (range:0.4-6.9), for the Veterans Affairs Medical Center (VAMC) and Rotterdam abdominal wound dehiscence risk score in the dehiscence and control groups, respectively. The area under the curve, on the ROC plot, was 0.84 and 0.76; this confirmed a good and moderate predictive value for the risk scores. The fit of the model was good in both cases, as shown by the Hosmer and Lemeshow test. CONCLUSIONS: Both the VAMC and Rotterdam scores can be used for the prediction of abdominal wound dehiscence. However, the VAMC prognostic score had better calibration and discriminative power when applied to the population in this study and taking into consideration our method of control selection

CONDITION OF MUNICIPAL WASTEWATER MANAGEMENT IN WIELKOPOLSKA IN THE YEARS 1999-2015

The article presents the development and condition of the sewage system in the cities and municipalities of Wielkopolska Voivodeship in the years 1999-2015. The data from Statistical Yearbook from Central Statistical Office – Environment Protection and Local Data Bank, and from National Programme for Municipal Waste Water Treatment implementation reports constituted the basis for the analysis. Over the last 16 years, the system of sewage management in municipalities has steadily improved. The study showed a heterogeneous state of development of the sewage network and wastewater treatment plant (WWTP), different growth of network, as well as variability in the share of the population using the sewage network. In last years the number of people who use the WWTP and sewage network has clearly increased. Moreover, the tendency for increasing amount of sewage treated in high performance technologies is observed. Unfortunately, this does not translate into significant improvements in the water quality in the region. Despite the clear improvement of the state of the sewage economy, it was not possible to fully achieve the assumptions arising from the National Programme for Municipal Waste Water Treatment, both in the voivodship and in the country

CHANGES IN THE TROPHIC STATUS OF LAKE NIEPRUSZEWSKIE (POLAND)

The paper presents the evaluation of trophic status of Lake Niepruszewskie in the years 1994–2013. This is the first lake in the Samica Stęszewska river, flowing distally through the lakes of the Wielkopolski National Park. Source part of the Samica Stęszewska river basin was, in the years 2004–2012, included to the nitrate vulnerable zone (NVZ), and Niepruszewskie Lake was considered to be threatened by eutrophication. The evaluation of trophic status of the lake was made based on the concentration of nutrients (nitrogen and phosphorus) and indicators of eutrophication (chlorophyll a, water transparency Secchi disk marked) by referring them to the limit values for the eutrophication of surface waters as defined in the Regulation of the Minister of Environment of 23 December 2002 and other criteria used for the classification of the eutrophication of surface waters. Detailed and synthetic indexes of the trophic status (TSI) using the formula Carlson and the ratio of N:P were also made. Concentrations of the nutrients in Lake Niepruszewskie and eutrophication indexes reached high values, indicating a eutrophic or hypertrophic state of the lake. Detailed values of the trophic status index (TSI), on average over the period, corresponded to eutrophic, while in subsequent years they were varied – from mesotrophic to hypertrophic. The worst trophic status was recorded in 2003–2006, after the lowering of the lake damming. The high value of N: P ratio indicates that the lake has huge surplus of nitrogen, and phosphorus is a productivity limiting factor

CHANGES IN THE TROPHIC STATUS OF LAKE NIEPRUSZEWSKIE (POLAND)

The paper presents the evaluation of trophic status of Lake Niepruszewskie in the years 1994–2013. This is the first lake in the Samica Stęszewska river, flowing distally through the lakes of the Wielkopolski National Park. Source part of the Samica Stęszewska river basin was, in the years 2004–2012, included to the nitrate vulnerable zone (NVZ), and Niepruszewskie Lake was considered to be threatened by eutrophication. The evaluation of trophic status of the lake was made based on the concentration of nutrients (nitrogen and phosphorus) and indicators of eutrophication (chlorophyll a, water transparency Secchi disk marked) by referring them to the limit values for the eutrophication of surface waters as defined in the Regulation of the Minister of Environment of 23 December 2002 and other criteria used for the classification of the eutrophication of surface waters. Detailed and synthetic indexes of the trophic status (TSI) using the formula Carlson and the ratio of N:P were also made. Concentrations of the nutrients in Lake Niepruszewskie and eutrophication indexes reached high values, indicating a eutrophic or hypertrophic state of the lake. Detailed values of the trophic status index (TSI), on average over the period, corresponded to eutrophic, while in subsequent years they were varied – from mesotrophic to hypertrophic. The worst trophic status was recorded in 2003–2006, after the lowering of the lake damming. The high value of N: P ratio indicates that the lake has huge surplus of nitrogen, and phosphorus is a productivity limiting factor