J. R. Giacolone1, S. Torres-Landa2, J. Cohen3,4, G. Hoeltzel2, R. Swendiman2, D. Dempsey2, N. Williams2, K. Dumon2 1Perelman School of Medicine at the University of Pennsylvania,Philadelphia, PA, USA 2Hospital Of The University Of Pennsylvania,Department Of Surgery,Philadelphia, PA, USA 3Hospital Of The University Of Pennsylvania,Department Of Medicine, Renal-Electrolyte And Hypertension Division,Philadelphia, PA, USA 4University Of Pennsylvania,Perelman School Of Medicine, Center For Clinical Epidemiology And Biostatistics,Philadelphia, PA, USA
Introduction: Patients operated for a PEH are often either underweight or obese; however, the association between all BMI classes and 30-day outcomes in patients who underwent laparoscopic hernia repairs has not been studied. The aim of this study was to evaluate the association between body mass index (BMI) and post-operative outcomes in elective hernia repairs.
Methods: We performed a retrospective study of patients who underwent an elective laparoscopic inguinal, femoral, umbilical, ventral, para-esophageal, epigastric and Spigelian hernia repair in the ACS NSQIP database (2005-2015). Patients were divided into BMI groups (< 18.5, 18.5 – 24.9, 25.0 – 29.9,30.0 – 34.9, 35 – 39.9,and ≥ 40.0 kg/m2). A multivariable logistic regression model was developed to characterize the association between BMI class and outcomes (mortality, readmission, reoperation, and overall complications).
Results: The median (IQR) age of the 9,641 patients who met inclusion criteria was 57 (46-67) and 36.8% were women. Across each BMI group, there were significant differences in age, race, gender, smoking status, frailty index, and ASA class (p < 0.05). Underweight BMI (<18.5) was associated with increased risk of readmission (OR = 1.61, p < 0.05). Patients with a BMI 25.0-29.9 (OR = 0.86), 30.0-34.9(OR = 0.86), 35-39.9 (OR = 0.81), and ≥ 40 (OR = 0.74) (p < 0.05) were associated with decreased readmission rates.
Conclusion: Underweight patients had an increased risk for readmissions but not for mortality after elective laparoscopic hernia repairs. Higher BMI was associated with a diminished risk for readmission, but not for mortality or reoperations. Overweight patients had a decreased risk for overall complications.
