Benner C, Spence K T, Childers W K
UPMC Harrisburg Department of Surgery, 205 S Front St, Harrisburg, PA, 17105, USA.
Hernia. 2022 Dec;26(6):1599-1604. doi: 10.1007/s10029-022-02572-3. Epub 2022 Feb 17.
Ventral hernia repairs (VHR) are among the most commonly performed operations by general surgeons. Despite advances in technology there remains high complication and readmission rates. Preoperative anemia has been linked to poor outcomes and readmission across several surgical procedures, however the link to ventral hernia repair outcomes is limited.
Utilizing the American College of Surgeons National Safety and Quality Improvement Project (NSQIP) database for years 2016-2018, a total of 115,000 patients met inclusion criteria. Using propensity matching we matched two groups of patients who underwent VHR: (1) those with preoperative anemia and (2) those with normal hemoglobin levels. Anemia criteria was set forth by the World Health Organization (WHO).
Univariate analysis did demonstrate statistical significance in post-operative outcomes percentage of serious surgical site infection, poor renal outcomes, transfusion, and unplanned remission in those with preoperative anemia who underwent VHR. In a multivariate analysis, patients who underwent ventral hernia repair with pre-operative anemia had significantly greater odds of unplanned readmission (odds ratio 1.35, 95% confidence interval 1.16-1.57) and serious surgical site infection (odds ratio 1.35, 95% confidence interval 1.04-1.74) independent of known risk factors such as smoking, diabetes and obesity.
Preoperative anemia is a risk factor for poor postoperative outcomes in those undergoing ventral hernia repair and should be considered when evaluating a patient for repair.
腹疝修补术（VHR）是普通外科医生最常开展的手术之一。尽管技术有所进步，但并发症和再入院率仍然很高。术前贫血与多种外科手术的不良预后和再入院有关，然而其与腹疝修补术预后的关联尚不明确。
利用美国外科医师学会国家质量改进项目（NSQIP）2016 - 2018年的数据库，共有115,000例患者符合纳入标准。我们采用倾向评分匹配法，将两组接受腹疝修补术的患者进行匹配：（1）术前贫血患者和（2）血红蛋白水平正常的患者。贫血标准由世界卫生组织（WHO）制定。
单因素分析确实表明，接受腹疝修补术的术前贫血患者在术后严重手术部位感染、肾功能不良、输血和意外再入院的发生率方面具有统计学意义。在多因素分析中，术前贫血的腹疝修补术患者发生意外再入院（比值比1.35，95%置信区间1.16 - 1.57）和严重手术部位感染（比值比1.35，95%置信区间1.04 - 1.74）的几率显著更高，且独立于吸烟、糖尿病和肥胖等已知风险因素。
术前贫血是腹疝修补术患者术后不良预后的一个风险因素，在评估患者是否适合修补时应予以考虑。
