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Elective ventral hernia repair provides significant abdominal wall quality of life improvements in older patients

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Abstract

Background

An increasing proportion of ventral hernia patients are over age 65. These patients are frequently offered watchful waiting rather than surgical intervention due to their frail state or perioperative risk. However, many in this age group suffer from significant quality of life impacts that are not well understood.

Methods

We performed a retrospective cohort study using data from the Abdominal Core Health Quality Collaborative (ACHQC), including adults undergoing elective ventral hernia repair from 2013 to 2019. Median differences in Hernia-Related Quality of Life Survey (HerQLes) summary scores at baseline, 30-days, 6-months, and 1 year post operatively were compared in four age categories (18–40, 40–64, 65–75, 76 +) using multivariable regression. Secondary outcomes included major post-operative complications and mortality.

Results

Of 6681 patients meeting inclusion criteria, 13.5% were 18–40, 55.8% were 41–64, 25.2% were 65–75, and 5% were 76 + . Patients in the 65–75 age group and those over 76 had higher mean baseline HerQLes scores (51.7 and 60.8) compared to those in the 18–40 and 41–64 groups (45 and 43.3, p < 0.01). Patients 65–75 had smaller increases in HerQLes scores at 30 days (6.7) compared to patients in the younger age groups (11.7 for 18–40; 8.3 for 41–64) and the oldest age group (8.3, p < 0.01). However, patients in the older age groups had higher overall median 1 year HerQles Scores (66.7 for 65–75; 78.3 for 76 +) compared to patients in the 18–40 and 41–64 age groups (65 and 58.3, p < 0.01). On multivariable analysis, HerQLes scores at 30 days post-surgery were decreased for patients in the 41–64 (−3.14, CE −5.89, −0.04, p = 0.03) and 65–75 (−4.53; CE −7.65, −1.41, p < 0.01) groups compared to the youngest age group, while those over 76 had no effect.

Conclusion

Older adults undergoing ventral hernia repair demonstrate equal gains in hernia-related quality of life compared to younger patients and actually report higher quality of life scores at 30 days, 6 months and, 1 year post-surgery.

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Authors and Affiliations

  1. Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA

    Courtney E. Collins, Savannah Renshaw, Anand Gupta, Heena Santry & Benjamin K. Poulose

  2. Center for Surgical Health Assessment, Research, and Policy (SHARP), Ohio State University Wexner Medical Center, Columbus, OH, USA

    Courtney E. Collins, Savannah Renshaw, Anand Gupta, Heena Santry & Benjamin K. Poulose

  3. Ohio State University Wexner Medical Center, 181 Taylor Ave, Suite 1102, Columbus, OH, 43203, USA

    Courtney E. Collins

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  1. Courtney E. Collins
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  2. Savannah Renshaw
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  5. Benjamin K. Poulose
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Correspondence to Courtney E. Collins.

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Disclosures

Dr. Courtney Collins, Savannah Renshaw, Anand Gupta, and Dr. Heena Santry do not have anything to disclose. Dr. Benjamin Poulose receives research support from Advanced Medical Solution, BD-Interventional and salary support from the Abdominal Core Health Quality Collaborative (ACHQC).

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Collins, C.E., Renshaw, S., Gupta, A. et al. Elective ventral hernia repair provides significant abdominal wall quality of life improvements in older patients. Surg Endosc 36, 1927–1935 (2022). https://doi.org/10.1007/s00464-021-08475-1

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  • DOI: https://doi.org/10.1007/s00464-021-08475-1

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