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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Predictive value of Hajibandeh index in determining peritoneal contamination in acute abdomen: A cohort study and meta-analysis
Shahab Hajibandeh, Shahin Hajibandeh, Louis Evans, Bethany Miller, Jennifer Waterman, Suhaib JS Ahmad, Jay Hale, Adnan Higgi, Bethan Johnson, Dafydd Pearce, Ahmed Hazem Helmy, Nader Naguib, Andrew Maw
Shahab Hajibandeh, Louis Evans, Bethany Miller, Jennifer Waterman, Department of General Surgery, University Hospital of Wales, Cardiff CF14 4XW, United Kingdom
Shahin Hajibandeh, Department of General Surgery, Royal Stoke University Hospital, Stoke-on-Trent ST4 6QG, United Kingdom
Suhaib JS Ahmad, Department of General Surgery, Ysbyty Gwynedd, Bangor LL57 2PW, United Kingdom
Jay Hale, Adnan Higgi, Bethan Johnson, Dafydd Pearce, Ahmed Hazem Helmy, Nader Naguib, Department of General Surgery, Royal Glamorgan Hospital, Pontyclun CF72 8XR, United Kingdom
Andrew Maw, Department of General Surgery, Glan Clwyd Hospital, Rhyl LL18 5UJ, United Kingdom
Co-first authors: Shahab Hajibandeh and Shahin Hajibandeh.
Author contributions: Hajibandeh S contributed to the conception and design of this study; Evans L, Miller B, Waterman J, Hale J, Higgi A, Johnson B, and Pearce D participated in the data collection; Hajibandeh S and Hajibandeh S took part in the analysis and interpretation of this manuscript, and wrote the article; all authors contributed to the critical revision of the article of this study; and all authors approved the final article.
Institutional review board statement: The study was conducted in accordance with institutions’ policies and internal arrangements approved by local Clinical Governance Unit. The study was a retrospective cohort study and meta-analysis involving non-identifiable data from hospital and electronic databases, hence patients’ consent and approval by Research Ethics Committees were not required.
Informed consent statement: The study was a retrospective cohort study and meta-analysis involving non-identifiable data from hospital and electronic databases, hence patients’ consent was not required.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data and materials related to this study will be available upon reasonable request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shahab Hajibandeh, MBChB, MRCS, Doctor, Researcher, Surgeon, Department of General Surgery, University Hospital of Wales, Heath Park Way, Cardiff CF14 4XW, United Kingdom. shahab_hajibandeh@yahoo.com
Received: September 29, 2023
Peer-review started: September 29, 2023
First decision: November 1, 2023
Revised: November 1, 2023
Accepted: December 1, 2023
Article in press: December 1, 2023
Published online: December 27, 2023
Processing time: 88 Days and 15.3 Hours
ARTICLE HIGHLIGHTS
Research background
Intraperitoneal contamination leads to increase in levels of C-reactive protein (CRP), lactate, neutrophils and lead to decrease in levels of lymphocytes and albumin. Hajibandeh index (HI), which includes CRP, neutrophils and lactate as nominators and albumin and lymphocytes as denominators, has been developed to predict peritoneal contamination and postoperative mortality in patients with acute abdominal pathology.
Research motivation
Presence of intraperitoneal contamination is an important predictor of morbidity and mortality in patients with acute abdominal pathology and it is taken into account by preoperative prognostic scoring tools. Therefore, early detection of intraperitoneal contamination is very important.
Research objectives
The objective of the study was to validate accuracy of HI in predicting the presence and nature of peritoneal contamination in patients with acute abdominal pathology.
Research methods
The STROBE guidelines and the PRISMA statement standards were followed to conduct a cohort study and a meta-analysis, respectively. The accuracy of the HI was evaluated using receiver operating characteristic curve analysis in the cohort study and using weighted summary area under the curve (AUC) under the fixed and random effects modelling in the meta-analysis.
Research results
Analysis of 1437 patients showed that HI can accurately predict the presence of peritoneal contamination in patients with acute abdominal pathology (AUC: 0.79, 95% confidence interval: 0.75-0.83).
Research conclusions
The HI is a strong and accurate predictor of intraperitoneal contamination in patients with acute abdominal pathology.
Research perspectives
HI is an objectively derived index from basic biomarkers and is worth attention for inclusion in emergency laparotomy preoperative risk assessment tools. It is a strong predictor of intraperitoneal contamination and postoperative mortality. The available evidence is robust but is limited to the studies conducted by our evidence synthesis group. The predictive performance of HI needs to be externally validated by other researchers.
