Outcomes of acute versus elective primary ventral hernia repair

Linda T. Li, Ryan J. Jafrani, Natasha S. Becker, Rachel L. Berger, Stephanie Hicks, Jessica A. Davila, Mike K. Liang

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The morbidity and mortality associated with acute primary ventral hernia repair have not been well described. We examined the rate of surgical site infection (SSI), hernia recurrence, and mortality in acute versus elective primary ventral hernia repair and identified predictors of morbidity and mortality after primary ventral hernia repair. METHODS: A retrospective study on all patients undergoing open primary ventral hernia repair at a single institution (2000-2010) was performed. Primary outcomes were mortality at any time, SSI, and recurrence. Survival analysis for the entire, unmatched sample was conducted. We performed a risk-adjusted analysis of outcomes using two methods as follows: (1) case matching and (2) propensity score-adjusted regression model. RESULTS: We identified 497 patients; 57 (11%) underwent acute primary ventral hernia repair. For the entire cohort, survival was worse for patients undergoing acute repair (log rank, 0.03). Following case matching on age, body mass index, American Society of Anesthesiologists score, and hernia size, there was no difference in mortality, SSI, or recurrence. After propensity score adjustment, acute surgery was not a predictor for mortality or SSI; however, incarcerated hernias predicted recurrence. CONCLUSION: After risk adjustment, acute primary ventral hernia repair was not associated with higher mortality, infection, or recurrence compared with elective repair. LEVEL OF EVIDENCE: Therapeutic study, level IV.

Original languageEnglish (US)
Pages (from-to)523-528
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume76
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

Fingerprint

Ventral Hernia
Herniorrhaphy
Surgical Wound Infection
Mortality
Recurrence
Hernia
Propensity Score
Morbidity
Risk Adjustment
Survival Analysis
Body Mass Index
Retrospective Studies
Survival
Infection

Keywords

  • Acute primary ventral hernia repair
  • emergency hernia repair
  • general surgery
  • mortality
  • outcomes research
  • surgical site infection
  • survival
  • umbilical hernia repair
  • ventral hernia repair

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Li, L. T., Jafrani, R. J., Becker, N. S., Berger, R. L., Hicks, S., Davila, J. A., & Liang, M. K. (2014). Outcomes of acute versus elective primary ventral hernia repair. Journal of Trauma and Acute Care Surgery, 76(2), 523-528. https://doi.org/10.1097/TA.0b013e3182ab0743

Outcomes of acute versus elective primary ventral hernia repair. / Li, Linda T.; Jafrani, Ryan J.; Becker, Natasha S.; Berger, Rachel L.; Hicks, Stephanie; Davila, Jessica A.; Liang, Mike K.

In: Journal of Trauma and Acute Care Surgery, Vol. 76, No. 2, 01.02.2014, p. 523-528.

Research output: Contribution to journalArticle

Li, LT, Jafrani, RJ, Becker, NS, Berger, RL, Hicks, S, Davila, JA & Liang, MK 2014, 'Outcomes of acute versus elective primary ventral hernia repair', Journal of Trauma and Acute Care Surgery, vol. 76, no. 2, pp. 523-528. https://doi.org/10.1097/TA.0b013e3182ab0743
Li, Linda T. ; Jafrani, Ryan J. ; Becker, Natasha S. ; Berger, Rachel L. ; Hicks, Stephanie ; Davila, Jessica A. ; Liang, Mike K. / Outcomes of acute versus elective primary ventral hernia repair. In: Journal of Trauma and Acute Care Surgery. 2014 ; Vol. 76, No. 2. pp. 523-528.
@article{c3ef117e4b284b1cbcd0ac219d17891f,
title = "Outcomes of acute versus elective primary ventral hernia repair",
abstract = "BACKGROUND: The morbidity and mortality associated with acute primary ventral hernia repair have not been well described. We examined the rate of surgical site infection (SSI), hernia recurrence, and mortality in acute versus elective primary ventral hernia repair and identified predictors of morbidity and mortality after primary ventral hernia repair. METHODS: A retrospective study on all patients undergoing open primary ventral hernia repair at a single institution (2000-2010) was performed. Primary outcomes were mortality at any time, SSI, and recurrence. Survival analysis for the entire, unmatched sample was conducted. We performed a risk-adjusted analysis of outcomes using two methods as follows: (1) case matching and (2) propensity score-adjusted regression model. RESULTS: We identified 497 patients; 57 (11{\%}) underwent acute primary ventral hernia repair. For the entire cohort, survival was worse for patients undergoing acute repair (log rank, 0.03). Following case matching on age, body mass index, American Society of Anesthesiologists score, and hernia size, there was no difference in mortality, SSI, or recurrence. After propensity score adjustment, acute surgery was not a predictor for mortality or SSI; however, incarcerated hernias predicted recurrence. CONCLUSION: After risk adjustment, acute primary ventral hernia repair was not associated with higher mortality, infection, or recurrence compared with elective repair. LEVEL OF EVIDENCE: Therapeutic study, level IV.",
keywords = "Acute primary ventral hernia repair, emergency hernia repair, general surgery, mortality, outcomes research, surgical site infection, survival, umbilical hernia repair, ventral hernia repair",
author = "Li, {Linda T.} and Jafrani, {Ryan J.} and Becker, {Natasha S.} and Berger, {Rachel L.} and Stephanie Hicks and Davila, {Jessica A.} and Liang, {Mike K.}",
year = "2014",
month = "2",
day = "1",
doi = "10.1097/TA.0b013e3182ab0743",
language = "English (US)",
volume = "76",
pages = "523--528",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Outcomes of acute versus elective primary ventral hernia repair

AU - Li, Linda T.

AU - Jafrani, Ryan J.

AU - Becker, Natasha S.

AU - Berger, Rachel L.

AU - Hicks, Stephanie

AU - Davila, Jessica A.

AU - Liang, Mike K.

PY - 2014/2/1

Y1 - 2014/2/1

N2 - BACKGROUND: The morbidity and mortality associated with acute primary ventral hernia repair have not been well described. We examined the rate of surgical site infection (SSI), hernia recurrence, and mortality in acute versus elective primary ventral hernia repair and identified predictors of morbidity and mortality after primary ventral hernia repair. METHODS: A retrospective study on all patients undergoing open primary ventral hernia repair at a single institution (2000-2010) was performed. Primary outcomes were mortality at any time, SSI, and recurrence. Survival analysis for the entire, unmatched sample was conducted. We performed a risk-adjusted analysis of outcomes using two methods as follows: (1) case matching and (2) propensity score-adjusted regression model. RESULTS: We identified 497 patients; 57 (11%) underwent acute primary ventral hernia repair. For the entire cohort, survival was worse for patients undergoing acute repair (log rank, 0.03). Following case matching on age, body mass index, American Society of Anesthesiologists score, and hernia size, there was no difference in mortality, SSI, or recurrence. After propensity score adjustment, acute surgery was not a predictor for mortality or SSI; however, incarcerated hernias predicted recurrence. CONCLUSION: After risk adjustment, acute primary ventral hernia repair was not associated with higher mortality, infection, or recurrence compared with elective repair. LEVEL OF EVIDENCE: Therapeutic study, level IV.

AB - BACKGROUND: The morbidity and mortality associated with acute primary ventral hernia repair have not been well described. We examined the rate of surgical site infection (SSI), hernia recurrence, and mortality in acute versus elective primary ventral hernia repair and identified predictors of morbidity and mortality after primary ventral hernia repair. METHODS: A retrospective study on all patients undergoing open primary ventral hernia repair at a single institution (2000-2010) was performed. Primary outcomes were mortality at any time, SSI, and recurrence. Survival analysis for the entire, unmatched sample was conducted. We performed a risk-adjusted analysis of outcomes using two methods as follows: (1) case matching and (2) propensity score-adjusted regression model. RESULTS: We identified 497 patients; 57 (11%) underwent acute primary ventral hernia repair. For the entire cohort, survival was worse for patients undergoing acute repair (log rank, 0.03). Following case matching on age, body mass index, American Society of Anesthesiologists score, and hernia size, there was no difference in mortality, SSI, or recurrence. After propensity score adjustment, acute surgery was not a predictor for mortality or SSI; however, incarcerated hernias predicted recurrence. CONCLUSION: After risk adjustment, acute primary ventral hernia repair was not associated with higher mortality, infection, or recurrence compared with elective repair. LEVEL OF EVIDENCE: Therapeutic study, level IV.

KW - Acute primary ventral hernia repair

KW - emergency hernia repair

KW - general surgery

KW - mortality

KW - outcomes research

KW - surgical site infection

KW - survival

KW - umbilical hernia repair

KW - ventral hernia repair

UR - http://www.scopus.com/inward/record.url?scp=84894108372&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894108372&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e3182ab0743

DO - 10.1097/TA.0b013e3182ab0743

M3 - Article

C2 - 24458061

AN - SCOPUS:84894108372

VL - 76

SP - 523

EP - 528

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 2

ER -