Predictors of mortality after elective ventral hernia repair: an analysis of national inpatient sample

Khorgami, Zhamak; Hui, Benedict; Mushtaq, Nasir; Chow, Geoffrey; Sclabas, Guido M.

doi:10.1007/s10029-018-1841-x

Cited by 29 publications

(20 citation statements)

References 19 publications

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“…Since, to date, only very few studies in the surgical literature have considered sex as a biological variable, the Journal Editors Group has called upon surgical scientists to publish more sex-specific studies [1][2][3][4]. Whereas for inguinal hernia sex differences were only recently recompiled [16,22], there is a paucity of publications on the influence of sex on the outcome after ventral-and incisional hernia-repair [12,13]. The large number of cases in registries are eminently suited to comparative studies of men vs women [23] since no patients are excluded and, at best, all other potential influence factors on the outcome are also taken into account.…”

Section: Discussionmentioning

confidence: 99%

“…There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair. Data from healthcare cost and utilization project-nationwide inpatient sample-on 59,993 elective ventral-and incisional hernia-repairs showed higher mortality for the male sex [12]. A prospective study of 887 ventraland incisional hernia-patients from the International Hernia Mesh Registry revealed an increased risk of chronic pain for the female gender [13].…”

Section: Introductionmentioning

confidence: 99%

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Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Köckerling

Hoffmann²,

Adolf

et al. 2019

Hernia

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Introduction To date, little attention has been paid by surgical scientific studies to sex as a potential influence factor on the outcome. Therefore, there is a sex bias in the surgical literature. With an incidence of more than 20% after 3 years, incisional hernias are a common complication following abdominal surgical procedures. The proportion of women affected is around 50%. There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair. Materials and methods In all, 22,895 patients with elective incisional hernia repair from the Herniamed Registry were included in the study. The patients had undergone elective incisional hernia repair in a laparoscopic IPOM, open sublay, open IPOM, open onlay or suture technique. 1-year follow-up was available for all patients. Propensity score matching was performed for the 11,480 female (50.1%) and 11,415 male (49.9%) patients, creating 8138 pairs (82.0%) within fixed surgical procedures. Results For pain on exertion (11.7% vs 18.3%; p < 0.001), pain at rest (7.53% vs 11.1%; p < 0.001), and pain requiring treatment (5.4% vs 9.1%; p < 0.001) highly significant disadvantages were identified for the female sex when comparing the different results within the matched pairs. That was also confirmed on comparing sex within the individual surgical procedures. No sex-specific differences were identified for the postoperative complications, complication-related reoperations or recurrences. Less favorable intraoperative complication results in the female sex were observed only for the onlay technique. Conclusions Female sex is an independent risk factor for chronic pain after elective incisional hernia repair.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Köckerling

Hoffmann²,

Adolf

et al. 2019

Hernia

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“…The weight of evidence from the systematic review supported that there was no significant mortality benefit between open and laparoscopic surgical techniques, this was found to be the case independent of hernia site, type and comorbidities 13–22 …”

Section: Discussionmentioning

confidence: 95%

“…Congestive heart failure, chronic pulmonary and hepatic disease, neurological disorders and paralysis were associated with a higher mortality risk 13,21,24 . Obesity was associated with an increased risk of respiratory failure 23 but not mortality 26 .…”

Section: Discussionmentioning

confidence: 98%

Elective abdominal wall hernia repair surgical mortality—A systematic review of the literature and peer review of mortality in Australia

Patiniott

Reid

Maloney

et al. 2021

ANZ Journal of Surgery

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Background This study systematically reviewed the literature regarding perioperative mortality in human adults undergoing elective surgical abdominal wall hernia repair, including an audit of the Royal Australasian College of Surgeons (RACS) Australian and New Zealand Audit of Surgical Mortality (ANZASM) database. Methods A systematic review was conducted in accordance with PRISMA guidelines for the reporting of systematic reviews and meta‐analysis of observational studies. Cochrane Library, PubMed, MEDLINE and Embase database searches and data extraction were conducted from June 1979 to October 2019. Statistical analysis was undertaken utilising denominator values for elective hernia procedures derived from the Australian Institute of Health and Welfare (AIHW) data. Risk‐adjusted perioperative mortality rates for the relevant procedures were also produced, using a binary logistic regression for the risk adjustment. Results Through systematic review of the literature, it was established that the overall reported perioperative mortality in human adults undergoing elective surgical abdominal wall hernia repair was low (0.1%–0.5%). Using ANZASM and AIHW data, the calculated risk‐adjusted mortality rate for Australian patients was found to be significantly lower (0.04%–0.06%, p < 0.001). Conclusion The risk‐adjusted mortality rate for elective abdominal wall hernia surgery in Australia is very low and compares favourably to international cohorts. Despite low absolute numbers, the factors which were most significantly associated with increased perioperative mortality in patients undergoing elective surgical abdominal wall hernia repair were increased age, cardiorespiratory co‐morbidity and incisional hernia repair.

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“…Hernia repair is one of the most common procedures for a general surgeon and costs billions of dollars to the health care system. 1 In particular, lumbar hernias commonly present as a palpable flank mass that increases in size with strenuous activity and/or intra-abdominal pressure. 2 These hernias protrude through weakened areas in the posterior-lateral abdominal wall at the superior or inferior lumbar triangles, resulting in Grynfeltt or Petit hernias, respectively.…”

mentioning

confidence: 99%

Minimally invasive repair of a lumbar hernia utilizing the subcutaneous space only

Clothier

Ward

Ebrahim

et al. 2019

Baylor University Medical Center Proceedings

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Lumbar hernias are from weakened areas in the posterior lateral abdominal wall. Minimally invasive techniques are recommended for nonmidline abdominal wall hernias. Endoscopic methods utilizing the subcutaneous space only are rarely reported. A 66-yearold man presented with abdominal pain and a computed tomography (CT) scan revealing a lumbar hernia. The procedure was done utilizing the subcutaneous space to open the hernia sac and repair the defect in layers. A sublay mesh and an onlay mesh were used within the subcutaneous pocket. The patient had an uneventful postoperative course and was discharged home. A subsequent CT scan showed that the completed repair remained intact. Few endoscopic lumbar hernia repairs are reported despite the advantageous aspects of the procedure in avoiding the peritoneal cavity and the retroperitoneum.

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Predictors of mortality after elective ventral hernia repair: an analysis of national inpatient sample

Cited by 29 publications

References 19 publications

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Elective abdominal wall hernia repair surgical mortality—A systematic review of the literature and peer review of mortality in Australia

Minimally invasive repair of a lumbar hernia utilizing the subcutaneous space only

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