Faculty Collaboration Database

Inpatient outcomes after elective versus nonelective ventral hernia repair. J Surg Res 2015 Oct;198(2):305-10

Date

05/20/2015

Pubmed ID

25982375

Pubmed Central ID

PMC4751026

DOI

10.1016/j.jss.2015.03.073

Scopus ID

2-s2.0-84940718376 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

BACKGROUND: Patients who present emergently with hernia-related concerns may experience increased morbidity with repair when compared with those repaired electively. We sought to characterize the outcomes of patients who undergo elective and nonelective ventral hernia (VH) repair using a large population-based data set.

MATERIALS AND METHODS: The Nationwide Inpatient Sample was queried for primary International Classification of Diseases, Ninth Revision codes associated with VH repair (years 2008-2011). Outcomes were inhospital mortality and the occurrence of a preidentified complication. Multivariable analysis was performed to determine the risk factors for complications and mortality after both elective and nonelective VH repair.

RESULTS: We identified 74,151 VH repairs performed during the study interval. Of these procedures, 67.3% were elective and 21.6% were performed laparoscopically. Nonelective repair was associated with a significantly higher rate of morbidity (22.5% versus 18.8%, P < 0.01) and mortality (1.8% versus 0.52, P < 0.01) than elective repair. Elective repairs were more likely to occur in younger patients, Caucasians, and were more likely to be performed laparoscopically. Logistic modeling revealed that female gender, Caucasian race, elective case status, and laparoscopic approach were independently associated with a lower probability of complications and mortality. Minority status and Medicaid payer status were associated with increased probability of nonelective admission.

CONCLUSIONS: Patients undergoing elective VH repair in the United States tend to be younger, Caucasian, and more likely to have a laparoscopic repair. Nonelective VH is associated with a substantial increase in morbidity and mortality. We recommend that patients consider elective repair of VHs because of the increased morbidity and mortality associated with nonelective repair.

Author List

Simon KL, Frelich MJ, Gould JC, Zhao HS, Szabo A, Goldblatt MI

Authors

Matthew I. Goldblatt MD Professor in the Surgery department at Medical College of Wisconsin
Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Elective Surgical Procedures
Emergency Medical Services
Female
Hernia, Ventral
Herniorrhaphy
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
United States