Complex abdominal wall hernia repair with biologic mesh in elderly: a propensity matched analysis.
Abdominal Wall
/ surgery
Acellular Dermis
/ adverse effects
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Animals
Bioprosthesis
/ adverse effects
Female
Hernia, Ventral
/ surgery
Herniorrhaphy
/ adverse effects
Humans
Male
Middle Aged
Propensity Score
Plastic Surgery Procedures
/ adverse effects
Reoperation
Retrospective Studies
Risk Adjustment
Surgical Mesh
/ adverse effects
Young Adult
Biologic mesh
Complex abdominal wall reconstruction
Complications
Elderly
Hernia
Outcomes
Posterior component release
Propensity matching
Journal
Hernia : the journal of hernias and abdominal wall surgery
ISSN: 1248-9204
Titre abrégé: Hernia
Pays: France
ID NLM: 9715168
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
10
07
2019
accepted:
04
10
2019
pubmed:
26
1
2020
medline:
21
4
2021
entrez:
26
1
2020
Statut:
ppublish
Résumé
Complex abdominal wall reconstruction (CAWR) has become a common surgical procedure both in non-elderly and elderly patients. The aim of this study is to analyze the outcomes of the elderly compared to nonelderly undergoing CAWR using propensity score matching. All patients who underwent CAWR using porcine-derived, non-crosslinked acellular dermal matrix (ADM) (Strattice™) between January 2014 and July 2017 were studied retrospectively. Propensity matched analysis was performed for risk adjustment in multivariable analysis and for one-to-one matching. The outcomes were analyzed for differences in postoperative complications, reoperations, mortality, hospital length of stay and adverse discharge disposition. One hundred-thirty-six patients were identified during the study period. Non-elderly (aged 18-64 years) constituted 70% (n = 95) and elderly (aged ≥ 65 years) comprised 30% of the overall patient population (n = 41). Seventy-three (56.7%) were females. After adjustment through the propensity score, which included 35 pairs, the surgical site infection (p = 1.000), wound necrosis (p = 1.000), the need for mechanical ventilation (p = 0.259), mortality (p = 0.083), reoperation rate (p = 0.141), hospital length of stay (p = 0.206), and discharge disposition (p = 0.795) were similar. Elderly patients undergoing CAWR with biological mesh have comparable outcomes with non-elderly patients when using propensity matching score.
Sections du résumé
BACKGROUND
Complex abdominal wall reconstruction (CAWR) has become a common surgical procedure both in non-elderly and elderly patients.
OBJECTIVE
The aim of this study is to analyze the outcomes of the elderly compared to nonelderly undergoing CAWR using propensity score matching.
METHODS
All patients who underwent CAWR using porcine-derived, non-crosslinked acellular dermal matrix (ADM) (Strattice™) between January 2014 and July 2017 were studied retrospectively. Propensity matched analysis was performed for risk adjustment in multivariable analysis and for one-to-one matching. The outcomes were analyzed for differences in postoperative complications, reoperations, mortality, hospital length of stay and adverse discharge disposition.
RESULTS
One hundred-thirty-six patients were identified during the study period. Non-elderly (aged 18-64 years) constituted 70% (n = 95) and elderly (aged ≥ 65 years) comprised 30% of the overall patient population (n = 41). Seventy-three (56.7%) were females. After adjustment through the propensity score, which included 35 pairs, the surgical site infection (p = 1.000), wound necrosis (p = 1.000), the need for mechanical ventilation (p = 0.259), mortality (p = 0.083), reoperation rate (p = 0.141), hospital length of stay (p = 0.206), and discharge disposition (p = 0.795) were similar.
CONCLUSION
Elderly patients undergoing CAWR with biological mesh have comparable outcomes with non-elderly patients when using propensity matching score.
Identifiants
pubmed: 31981009
doi: 10.1007/s10029-019-02068-7
pii: 10.1007/s10029-019-02068-7
pmc: PMC7223233
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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