Leveraging a statewide quality collaborative to understand population-level hernia care - 29/11/21
, Anne Ehlers a, b, Lia Delaney c, Quintin Solano c, Michael Englesbe a, d, Justin Dimick a, e, Dana Telem a, e, ⁎ Abstract |
Background |
Although ventral hernia repair (VHR) is extremely common, there is profound variation in operative technique and outcomes. This study describes the results of a statewide registry capturing hernia-specific variables to understand population-level practice patterns.
Methods |
Retrospective analysis of adult patients in a new statewide hernia registry undergoing VHR in 2020.
Results |
919 patients underwent VHR across 57 hospitals and 279 surgeons. Hernia width was <2 cm in 233 (25%) patients, 2–5 cm in 420 (46%) patients, 5–10 cm in 171 (19%) patients, and >10 cm in 95 (10%) patients. Mesh was used in 79% of cases and varied in use from 53% of hernias <2 cm to 95% of hernias >10 cm. The most common mesh type was synthetic non-absorbable (46%), followed by synthetic absorbable mesh (37%). The incidence of complications was significantly associated with hernia width.
Conclusions |
A population-level, hernia-specific database captured operative details for 919 patients in 1 year. There was significant variation in mesh use and outcomes based on hernia size. These nuanced data may inform higher quality clinical practice.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Mesh use, mesh type, and mesh placement varied substantially across 919 patients undergoing ventral hernia repair. |
• | Synthetic non-absorbable mesh was the most common type (46%) followed by synthetic absorbable mesh (37%). |
• | The incidence of complications was significantly associated with hernia width. |
• | This may represent an opportunity to standardize surgical practice in order to improve patient outcomes. |
Keywords : Hernia, Hernia repair, Outcomes, Surgery, Variation
Plan
Vol 222 - N° 5
P. 1010-1016 - novembre 2021 Retour au numéro
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