The association of hernia-specific and procedural risk factors with early complications in ventral hernia repair: ACHQC analysis.

Background: Many surgical risk assessment tools emphasize patient-specific risk factors. Our objective was to use a hernia-specific database to assess risk factors of complications in ventral hernia repair (VHR) focusing on hernia-specific and procedural factors.
Methods: The ACHQC database was queried for elective VHR in adults from 2012 to 2023. Primary outcome was overall 30-day complications. Multivariable logistic regression was used for analysis.
Results: 41,526 VHR were included. The rate of 30-day complications was 18%, surgical site infection 3%, surgical site occurrence requiring procedural intervention 4%, readmission 4%, reoperation 2%, and mortality 0.2%. Multivariable analysis demonstrated that BMI, ASA, frailty, COPD, anticoagulants, defect width, incisional and recurrent hernias, presence of stoma or prior mesh, prior abdominal wall infection, non-clean wound, operative time, open approach and myofascial release were associated with 30-day complications (OR ​= ​1.01-1.66). Preoperative chlorhexidine, bowel preparation and fascial closure were associated with lower complication risk (OR ​= ​0.70-0.89).
Conclusion: Hernia and procedural risk factors are associated with early complications following elective VHR. These factors need to be included in surgical risk assessment tools, to supplement patient-specific factors.
Competing Interests: Declaration of competing interest Mazen R. Al-Mansour received speaker feeds from Medtronic Inc, Honorarium from AbbVie Inc and general payments from Davol Inc and W. L. Gore & Associates, Inc. Delaney D. Ding, Celeste G. Yergin, Robert Tamer and Li-Ching Huang have no disclosures to report.
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