• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • 2022 NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Predictors of Mortality after Elective Ventral Hernia Repair: An Analysis of National Inpatient Sample

Zhamak Khorgami, MD, Benedict Y Hui, MD, Guido M Sclabas, MD. University of Oklahoma – Tulsa

Introduction: Ventral hernia (VH) is a common surgical problem and can present both as emergent and elective cases. Deciding between surgery and non-operative management of a non-obstructive VH in a high-risk patient can sometimes be a challenge. The aim of this study was to evaluate national series of open and laparoscopic ventral hernia repair (VHR), and to assess factors associated with mortality after elective VHR.

Method: In a retrospective analysis of 2008-2014 Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS), we included all patients with the main diagnosis of abdominal cavity hernia (except inguinal, femoral, and diaphragmatic), and a Diagnosis Related Group (DRG) code related to hernia procedures except inguinal and femoral. Elective and Laparoscopic VHR were identified. Factors associated with the same hospitalization mortality were analyzed using logistic regression multivariate analysis.

Results: A total of 103,635 patients were studied (mean age 57.3±15.3 years, 61.4% female). There were 14,787 (14.3%) umbilical, 63,685 (61.5%) incisional, and 25,163 (24.3%) other ventral hernias. 215 (0.2%) patients had gangrenous hernia contents. Operative procedures included 59,993 (57.9%) elective and 43,642 (42.1%) emergent VHR.  21.3% elective VHR were laparoscopic versus 13% in emergent cases (P<0.001). Mesh was used in 52,642 (87.7%) elective VHR versus 27,734 (63.5%) emergent VHR (P<0.001). Mortality was 0.2% (n=135) in the elective and 0.6% (n=269) in emergent surgery group (P<0.001). In the elective surgery group, mortality rates were equal among laparoscopic and open VHR (0.2%), while in the emergent surgery group, laparoscopic VHR had a lower mortality rate (0.4% vs 0.6%, P=0.028). In the entire cohort, the median (interquartile range) of length of stay was 2 (3) days in the laparoscopic group and 3 (3) days in the open group (P<0.001), with no significant difference in total hospital charges. Multivariate analysis of elective VHR showed that the following factors were associated with mortality during hospitalization: male gender (Odds Ratio(OR)=2.37), age>50 years (OR=1.96), congestive heart failure (OR=2.15), pulmonary circulation disorders (OR=5.26), coagulopathy (OR=3.93), liver disease (OR=1.89), fluid and electrolyte disturbances (OR=8.66), metastatic cancer (OR=4.66), neurological disorders (OR=2.31), and paralysis (OR=5.29) (Table).

Conclusion: VHR has a low mortality rate, especially when performed laparoscopically. When planning for elective VHR, higher mortality is to be expected in older patients with comorbidities, especially patients with congestive heart failure, pulmonary circulation disorders, coagulopathy, chronic liver disease, metastatic cancer, neurological disorders, and paralysis. Conservative management should be more considered for these high-risk subgroups. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87602

Program Number: S013

Presentation Session: Outcomes/Quality Session

Presentation Type: Podium

75

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2018 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons