Variation in mesh placement for ventral hernia repair: an opportunity for process improvement? - 22/08/11
Corresponding author. Tel.: +1-205-975-1932; fax: +1-205-996-4959.Abstract |
Background |
Incisional hernia repair (IHR) with mesh has been associated with decreased hernia recurrence. We analyzed variation in mesh use for IHR.
Methods |
A cohort undergoing IHR from 16 Veterans' Administration (VA) Hospitals was identified. Patient-specific variables were obtained from National Surgical Quality Improvement Program (NSQIP) data. Operative variables were obtained from physician-abstracted operative notes. Univariate and multivariable logistic regression analyses were used to model mesh implantation predictors.
Results |
A total of 1,123 IHR cases were analyzed; Mesh was implanted in 69.6% (n = 781). Regression models demonstrated repair at a high performing facility was associated with a nearly 4-fold increase in mesh utilization. Other significant predictors include repair of recurrent hernia, chronic steroid use, and multiple fascial defects.
Conclusions |
There is variation in the rate of mesh placement for IHR by VA facility, even after accounting for key explanatory variables. Patterns of mesh placement in IHR appear to be based on practice style.
Le texte complet de cet article est disponible en PDF.Keywords : Incisional hernia repair, Variation, Quality
Plan
| Supported by the Health Services Research and Development Program of the Department of Veterans Affairs Office of Research and Development and Grant No. 5 T32 HS013852 from the Agency for Healthcare Research and Quality. |
Vol 196 - N° 2
P. 201-206 - août 2008 Retour au numéro
Article précédent
- Bile leak after hepatectomy: Predictive factors of spontaneous healing
- Luca Viganò, Alessandro Ferrero, Enrico Sgotto, Roberto Lo Tesoriere, Marco Calgaro, Lorenzo Capussotti
- Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases
- John D. Horton, Kent J. DeZee, Eric P. Ahnfeldt, Michel Wagner
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?