Preoperative Functional Health Status Impacts Outcomes after Ventral Hernia Repair

2012 ◽  
Vol 78 (2) ◽  
pp. 230-234 ◽  
Author(s):  
Emily L. Albright ◽  
Daniel L. Davenport ◽  
J. Scott Roth

Associated with the aging population is an increase in comorbidities and a decrease in the ability to perform basic daily activities. This is tracked within the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) as a patient's preoperative functional health status. Our goal was to evaluate the impact of preoperative functional status upon outcomes after ventral hernia repair. We reviewed all cases of patients that underwent ventral hernia repair from 2005 to 2010 in the ACS-NSQIP database. Patients were identified based on selected Current Procedural Terminology codes and grouped based on functional status as listed in the ACS-NSQIP database—independent, partially dependent, and totally dependent. Preoperative and operative variables were recorded for all patients. Clinical risk factors and short-term outcomes between groups were compared. Multivariable logistic regression was used to adjust for age, wound class, American Society of Anesthesiologists class, and case relative value units. A total of 76,397 patients were identified: 74,785 were independent (97.9%), 1,317 partially dependent (1.7%), and 295 totally dependent (0.4%). Totally dependent patients had an increased risk for all short-term outcomes after ventral hernia repair: wound occurrence, pneumonia, pulmonary embolism, urinary tract infection, myocardial infarction, deep venous thrombosis, sepsis, return to the operating room, and death ( P < 0.001 for all).

Hernia ◽  
2014 ◽  
Vol 19 (5) ◽  
pp. 827-833 ◽  
Author(s):  
S. F. Tam ◽  
J. T. Au ◽  
P. J. Chung ◽  
A. Duncan ◽  
A. E. Alfonso ◽  
...  

2019 ◽  
Vol 85 (11) ◽  
pp. 1213-1218
Author(s):  
Sarah S. Fox ◽  
Li-Ching Huang ◽  
W. Borden Hooks ◽  
John P. Fischer ◽  
William W. Hope

The best method for fascial closure during hernia repair remains unknown. This study evaluates the impact of fascial closure techniques on short-term outcomes. All patients undergoing open ventral hernia repair were queried using the Americas Hernia Society Quality Collaborative database. Analysis was stratified by suture type (absorbable and permanent) and technique (figure-of-eight, running, and interrupted). Outcome measures included SSI, surgical site occurrence (SSO), SSO requiring intervention, recurrence rate, and quality of life. Descriptive statistics and logistic regression were used. The study included 6544 patients. Two-thirds of surgeons closed fascia during ventral hernia repair with absorbable suture and one-third with permanent suture. In the absorbable group, 17 per cent used figure-of-eight, 46 per cent running, and 4 per cent interrupted suture. In the permanent group, 13 per cent used figure-of-eight, 8 per cent running, and 11 per cent interrupted suture. There was no significant association between SSO and closure technique ( P = 0.2). However, SSO and suture type were significant ( P < 0.001) with the odds of SSO for closure with absorbable suture being 62 per cent higher than the odds of permanent. Fascial closure technique and suture type had no significant association ( P > 0.5) with SSI, SSO requiring intervention, hernia recurrence rate, or HerQLes or NIH PROMIS 3a scores at 30 days or 6 months. Fascial closure technique and suture material do not have a major impact on outcomes in ventral hernia repair. Despite a significantly higher rate of SSO for absorbable sutures than permanent, this did not increase the rate of interventions.


Hernia ◽  
2019 ◽  
Vol 23 (5) ◽  
pp. 899-907 ◽  
Author(s):  
L. Owei ◽  
R. A. Swendiman ◽  
S. Torres-Landa ◽  
D. T. Dempsey ◽  
K. R. Dumon

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