R. Conway1, M. Zhao3, Y. Zeng2, J. Keith1 1University Of Iowa Hospitals & Clinics,Department Of General Surgery,Iowa City, IA, USA 2University Of Iowa,Department Of Biostatistics,Iowa City, IA, USA 3University Of Iowa,Carver College Of Medicine,Iowa City, IA, USA
Introduction: Ventral hernia-repair (VHR) is a common surgical procedure and often performed on patients with comorbid conditions such as chronic obstructive pulmonary disease (COPD), history of smoking, and previous surgical complications. Postoperative complications following VHR present patient morbidity and high cost to the medical system. Therefore, our aim was to determine if any correlation exists between preoperative co-morbid conditions and postoperative outcomes in patients undergoing VHR.
Methods: A retrospective chart review of 304 patients who underwent VHR at UIHC from 2010-2011 was performed. Multiple variables were investigated including the presence of ventral hernia recurrence, surgical site infection, readmission, and need for reoperation. A multivariable logistic regression model was developed to examine potential effects of independent variables on postoperative outcomes.
Results: A history of smoking (OR=1.03, p=0.004) and prior surgical site infection (OR=2.88, p=0.02) were associated with a significant increase in surgical site infection following VHR. Recurrence following VHR was significantly more likely in patients with a history of prior abdominal surgery (OR=1.31, p<0.001). A history of COPD increased the risk for second readmission following VHR (OR=11.9, p=0.02). Prior surgical site infection (OR=3.33, p=0.002) and history of COPD (OR=3.32, p=0.03) were associated with a significant increase in reoperation following VHR. (Table 1)
Conclusion: A preoperative diagnosis of COPD and a history of prior abdominal surgery, prior surgical site infection, and smoking all increase the risk for postoperative complications in patients who undergo VHR. More studies are needed to better understand the pathophysiology involved and how to reduce postoperative complications in VHR.
