Optimizing patient selection in ventral hernia repair with concurrent panniculectomy: An analysis of 1974 patients from the ACS-NSQIP datasets

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2014-11, Vol.67 (11), p.1532-1540
• Main Authors: Fischer, John P, Basta, Marten N, Wink, Jason D, Wes, Ari M, Kovach, Stephen J
• Format: Article
• Language: English
• Subjects: Abdominoplasty - methods; ACS-NSQIP; Body Mass Index; Concurrent panniculectomy; Female; Hernia repair; Hernia, Ventral - surgery; Herniorrhaphy - methods; Humans; Lipectomy - methods; Male; Middle Aged; Outcomes; Patient Selection; Plastic Surgery; Postoperative Complications - etiology; Risk Assessment; Risk model
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2014.07.001

Summary Background Panniculectomy (PAN) during ventral hernia repair (VHR) can be a challenging procedure associated with added risk. We utilized the ACS-NSQIP datasets to generate a risk model of morbidity following these combined interventions. Methods The 2005–2012 ACS-NSQIP databases were queried to identify all patients undergoing VHR-PAN. Multivariate logistic regression analyses were used to assess perioperative factors associated with surgical and medical morbidity. Internal validation was performed using bootstrap analysis and risk stratification was performed using weighted β-coefficients. Results 1974 patients underwent VHR-PAN with an average age of 53.6 ± 12.4 years and BMI of 36.4 ± 10.1 kg/m2. Surgical complications occurred in 23.8% of patients, whereas medical complications occurred in 11.5%. A multivariate logistic regression identified the presence of a renal comorbidity (OR = 1.62, P  = 0.045), class II obesity (BMI = 34.9–40.0 kg/m2) (OR = 1.89, P