Impact of body mass index on minimally invasive ventral hernia repair: an ACS-NSQIP analysis.

Purpose: Body mass index (BMI) ≥ 35 kg/m2 is a known independent risk factor for complications following open ventral hernia repair (VHR). We sought to examine the relationship between BMI and minimally invasive VHR.Methods: The ACS-NSQIP database was queried for all patients age ≥ 18 years undergoi...

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Publicado en:Hernia Vol. 23; no. 5; pp. 899 - 908
Autores principales: Owei, L., Swendiman, R. A., Torres-Landa, S., Dempsey, D. T., Dumon, K. R.
Formato: Journal Article
Publicado: Springer Nature Oct2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2019
      vid: 23
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10029-019-01944-6
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        atl: Impact of body mass index on minimally invasive ventral hernia repair: an ACS-NSQIP analysis.
      aug:
        au:
          Owei, L.
          Swendiman, R. A.
          Torres-Landa, S.
          Dempsey, D. T.
          Dumon, K. R.
        affil: Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
      sug:
        subj:
          Herniorrhaphy Methods
          Herniorrhaphy Adverse Effects
          Hernia Surgery
          Postoperative Complications Epidemiology
          Hernia Epidemiology
          Body Mass Index
          Obesity, Morbid Diagnosis
          Obesity, Morbid Epidemiology
          Risk Assessment
          Adult
          Male
          Resource Databases
          Middle Age
          United States
          Risk Factors
          Comorbidity
          Female
          Minimally Invasive Procedures Methods
          Impact of Events Scale
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: Body mass index (BMI) ≥ 35 kg/m2 is a known independent risk factor for complications following open ventral hernia repair (VHR). We sought to examine the relationship between BMI and minimally invasive VHR.Methods: The ACS-NSQIP database was queried for all patients age ≥ 18 years undergoing minimally invasive VHR (2005-2015). Patients were stratified into seven BMI classes: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5-24.9), overweight (25-29.9), obese (30-34.5), severely obese (35-39.9), morbidly obese (40-49.9), and super obese (BMI ≥ 50), as well as by hernia type (reducible vs. strangulated) and time of repair (initial vs. recurrent). Multivariate logistic regression was employed to assess the risk of complication by BMI class.Results: A total of 55,180 patients met inclusion criteria, and 61.4% had a BMI > 30 kg/m2. When stratified by BMI class, we found significant differences in age, gender, race, comorbidities, and pre-operative characteristics across groups. The overall complication rate was 4.0%, ranging from 3.0% for normal BMI patients, to 6.9% for patients with a BMI ≥ 50 kg/m2. Recurrent repairs and strangulated hernias both demonstrated higher complication rates. All complications (surgical and medical) were significantly associated with BMI class after adjustment (p < 0.0001). Patients with a BMI ≥ 50 kg/m2 had a 1.4 times greater risk for complications than patients with normal BMIs (18-24.9 kg/m2, p = 0.01).Conclusion: BMI ≥ 50 kg/m2 was determined to be an independent risk factor for surgical and medical complications after minimally invasive VHR.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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