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CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.
Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.
The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.
The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.
They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.
In addition to wound infection, preoperative BMI greater than 35 kg/m
Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.
Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.
Dr. Nelson said she had no relevant disclosures.
CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.
Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.
The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.
The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.
They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.
In addition to wound infection, preoperative BMI greater than 35 kg/m
Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.
Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.
Dr. Nelson said she had no relevant disclosures.
CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.
Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.
The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.
The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.
They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.
In addition to wound infection, preoperative BMI greater than 35 kg/m
Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.
Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.
Dr. Nelson said she had no relevant disclosures.