Department of Surgery, Rutgers, New Jersey Medical School, Newark, New Jersey.
Department of Surgery, Rutgers, New Jersey Medical School, Newark, New Jersey.
J Surg Res. 2019 Jul;239:284-291. doi: 10.1016/j.jss.2019.02.016. Epub 2019 Mar 18.
Solid organ transplant has been identified as an independent risk factor in ventral hernia repair. Previous studies have generally focused on case studies or small samples. We sought to investigate the impact of liver or kidney transplant on ventral hernia repair outcomes using a nationally representative sample.
The National Inpatient Sample was used to identify ventral hernia repairs from years 2005 to 2014. We then divided them into two groups, patients with prior solid organ transplant and those without, and used logistic regression to analyze the effect of this variable on outcomes. We then investigated the relationship between various comorbidities and 30-d outcomes of surgery in both groups after adjusting for comorbidities. The primary outcome we looked at was mortality, with secondary outcomes such as length of stay and various surgical complications.
We compared two groups consisting of patients with prior transplant (n = 3317) and patients without (n = 372,775) and found that patients with prior liver or kidney transplant did not have higher mortality rates and also did not have longer lengths of stay. In addition, in terms of preoperative variables, patients with transplant were more likely to have the following comorbidities: cardiac arrhythmia, chronic blood loss anemia, chronic pulmonary disease, congestive heart failure, depression, metastatic cancer, obesity, psychoses, solid tumor without metastasis, and weight loss. Diabetes was associated with higher mortality in transplant patients.
Patients without prior liver or kidney transplant did not have higher mortality rates or lengths of stay.
实体器官移植已被确定为腹疝修补术的独立危险因素。先前的研究通常集中在病例研究或小样本上。我们试图使用全国代表性样本研究肝或肾移植对腹疝修复结果的影响。
使用国家住院患者样本确定 2005 年至 2014 年的腹疝修复病例。然后我们将它们分为两组,一组是有既往实体器官移植史的患者,另一组是没有既往实体器官移植史的患者,并使用逻辑回归分析该变量对结果的影响。然后,我们在调整了合并症后,研究了两组中各种合并症与 30 天手术结果之间的关系。我们观察的主要结果是死亡率,次要结果包括住院时间和各种手术并发症。
我们比较了两组患者,一组是有既往移植史(n=3317)的患者,另一组是没有既往移植史(n=372775)的患者,发现有既往肝或肾移植史的患者死亡率并没有更高,住院时间也没有更长。此外,在术前变量方面,有移植史的患者更有可能患有以下合并症:心律失常、慢性失血性贫血、慢性肺部疾病、充血性心力衰竭、抑郁、转移性癌症、肥胖、精神疾病、无转移的实体瘤和体重减轻。糖尿病与移植患者的死亡率较高有关。
没有既往肝或肾移植史的患者死亡率或住院时间没有更高。