The impact of frailty on ventral hernia repair outcomes in a statewide database
- 07.11.2022
- 2022 SAGES Oral
Erschienen in:
- Verfasst von
- Quintin P. Solano
- Ryan Howard
- Cody L. Mullens
- Anne P. Ehlers
- Lia D Delaney
- Brian Fry
- Mary Shen
- Michael Englesbe
- Justin Dimick
- Dana Telem
- Erschienen in
- Surgical Endoscopy | Ausgabe 7/2023
Abstract
Introduction
Preoperative frailty is a strong predictor of postoperative morbidity in the general surgery population. Despite this, there are a paucity of research examining the effect of frailty on outcomes after ventral hernia repair (VHR), one of the most common abdominal operations in the USA. We examined the association of frailty with short-term postoperative outcomes while accounting for differences in preoperative, operative, and hernia characteristics.
Methods
We retrospectively reviewed the Michigan Surgery Quality Collaborative Hernia Registry (MSQC-HR) for adult patients who underwent VHR between January 2020 and January 2022. Patient frailty was assessed using the validated 5-factor modified frailty index (mFI5) and categorized as follows: no (mFI5 = 0), moderate (mFI5 = 1), and severe frailty (mFI5 ≥ 2). Our primary outcome was any 30-day complication. Multivariable logistic regression was used to evaluate the association of frailty with outcomes while controlling for patient, operative, and hernia variables.
Results
A total of 4406 patients underwent VHR with a mean age (SD) of 55 (15) years, 2015 (46%) females, and 3591 (82%) white patients. The mean (SD) BMI of the cohort was 33 (8) kg/m2. A total of 2077 (47%) patients had no frailty, 1604 (36%) were moderately frail, and 725 (17%) were severely frail. The median hernia size (interquartile range) was 2.5 cm (1.5–4.0 cm). Severe frailty was associated with increased odds of any complication (adjusted Odds Ratio (aOR) 3.12, 95% CI 1.78–5.47), serious complication (aOR 5.25, 95% CI 2.17–13.19), SSI (aOR 3.41, 95% CI 1.58–7.34), and post-discharge adverse events (aOR 1.70, 95% CI 1.24–2.33).
Conclusion
After controlling for patient, operative, and hernia characteristics, frailty was independently associated with increased odds of postoperative complications. These findings highlight the importance of preoperative frailty assessment for risk stratification and to inform patient counseling.
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- Titel
- The impact of frailty on ventral hernia repair outcomes in a statewide database
- Verfasst von
-
Quintin P. Solano
Ryan Howard
Cody L. Mullens
Anne P. Ehlers
Lia D Delaney
Brian Fry
Mary Shen
Michael Englesbe
Justin Dimick
Dana Telem
- Publikationsdatum
- 07.11.2022
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 7/2023
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-022-09626-8
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