Risk factor analysis and prediction modeling for the occurrence of perioperative complications in abdominal wall incisional hernia patients

Abstract

Aim: The occurrence of perioperative complications in patients with abdominal wall incisional hernia not only affects their postoperative recovery but also increases their financial burden and pain. Therefore, the influencing factors predicting the occurrence of perioperative complications in abdominal wall incisional hernia should be determined, so that clinicians can perform perioperative patient management and early interventions before surgery to reduce the occurrence of complications. Methods: This retrospective analysis included 212 patients with incisional hernia of the abdominal wall in Shaanxi Provincial People’s Hospital from January 2013 to December 2020. The least absolute shrinkage and selection operator regression model was applied to optimize factor selection, and multivariable logistic regression analysis was conducted to construct a predictive model. The performance and clinical utility of the nomogram were determined, and internal validation was conducted. Results: The prediction nomogram showed that abnormal preoperative pulmonary function, defect in the central region of the anterior abdominal wall, hernia size, and intraoperative bleeding were predictors of perioperative complications in abdominal wall incisional hernia. The model showed an area under the receiver operating characteristic curve of 0.771 (95% confidence interval: 0.687–0.767). Decision curve analysis demonstrated that the perioperative complications risk nomogram had a good net clinical benefit. Conclusions: We developed a nomogram to help clinicians identify abdominal wall incisional hernia patients who are at a greater risk of perioperative complications, which may aid in early intervention and reduce the incidence of perioperative complications in them.