Leveraging a statewide quality collaborative to understand population-level hernia care.
Female
Hernia, Ventral
/ surgery
Herniorrhaphy
/ instrumentation
Humans
Male
Michigan
Middle Aged
Practice Patterns, Physicians'
/ statistics & numerical data
Quality Improvement
/ organization & administration
Registries
Retrospective Studies
Surgical Mesh
/ statistics & numerical data
Treatment Outcome
Hernia
Hernia repair
Outcomes
Surgery
Variation
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
12
04
2021
revised:
09
05
2021
accepted:
25
05
2021
pubmed:
7
6
2021
medline:
22
12
2021
entrez:
6
6
2021
Statut:
ppublish
Résumé
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. Retrospective analysis of adult patients in a new statewide hernia registry undergoing VHR in 2020. 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. 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.
Sections du résumé
BACKGROUND
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
METHODS
Retrospective analysis of adult patients in a new statewide hernia registry undergoing VHR in 2020.
RESULTS
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
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.
Identifiants
pubmed: 34090661
pii: S0002-9610(21)00293-2
doi: 10.1016/j.amjsurg.2021.05.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1010-1016Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.