■先前的工作已将体重指数(BMI)与腹侧疝修补术(VHR)的术后结局联系起来,尽管最近表征这种关联的数据有限。本研究使用当代国家队列研究BMI和VHR结果之间的关系。
■成人≥18岁接受隔离,选修,使用2016-2020年美国外科医生学会国家外科质量改善计划数据库确定了主要VHR.患者按BMI分层。使用受限制的三次样条来确定BMI阈值,以显着增加发病率。开发了多变量模型来评估BMI与感兴趣的结果的关联。
■在约89,924名患者中,0.5%被认为是体重不足,12.9%正常体重,29.5%超重,29.1%第一类,16.6%II类,9.7%III类,和1.7%的超级肥胖。风险调整后,I类(调整后赔率比[AOR]1.22,95%置信区间[95CI]:1.06-1.41),II类(AOR1.42,95CI:1.21-1.66),III类肥胖(AOR1.76,95CI:1.49-2.09)和超级肥胖(AOR2.25,95%CI:1.71-2.95)与开放后相对于正常BMI的总体发病率增加相关。但不是腹腔镜,VHR。BMI为32被确定为预测发病率最显着增加的阈值。BMI的增加与手术时间和术后住院时间的逐步增加有关。
■BMI≥32与开放后更高的发病率相关,但不是腹腔镜VHR.BMI的相关性在开放式VHR中可能更明显,必须考虑对风险进行分层,改善结果,优化护理。
■体重指数(BMI)仍然是选择性开放式腹侧疝修补术(VHR)的发病率和资源使用的相关因素。32的BMI是开放VHR后总体并发症显着增加的阈值,尽管在腹腔镜手术中未观察到这种关联。
UNASSIGNED: Prior work has linked body mass index (BMI) with postoperative outcomes of ventral hernia repair (VHR), though recent data characterizing this association are limited. This study used a contemporary national cohort to investigate the association between BMI and VHR outcomes.
UNASSIGNED: Adults ≥ 18 years undergoing isolated, elective, primary VHR were identified using the 2016-2020 American College of Surgeons National Surgical Quality Improvement Program database. Patients were stratified by BMI. Restricted cubic splines were utilized to ascertain the BMI threshold for significantly increased morbidity. Multivariable models were developed to evaluate the association of BMI with outcomes of interest.
UNASSIGNED: Of ~89,924 patients, 0.5 % were considered Underweight, 12.9 % Normal Weight, 29.5 % Overweight, 29.1 % Class I, 16.6 % Class II, 9.7 % Class III, and 1.7 % Superobese. After risk adjustment, class I (Adjusted Odds Ratio [AOR] 1.22, 95 % Confidence Interval [95%CI]: 1.06-1.41), class II (AOR 1.42, 95%CI: 1.21-1.66), class III obesity (AOR 1.76, 95%CI: 1.49-2.09) and superobesity (AOR 2.25, 95 % CI: 1.71-2.95) remained associated with increased odds of overall morbidity relative to normal BMI following open, but not laparoscopic, VHR. A BMI of 32 was identified as the threshold for the most significant increase in predicted rate of morbidity. Increasing BMI was linked to a stepwise rise in operative time and postoperative length of stay.
UNASSIGNED: BMI ≥ 32 is associated with greater morbidity following open, but not laparoscopic VHR. The relevance of BMI may be more pronounced in open VHR and must be considered for stratifying risk, improving outcomes, and optimizing care.
UNASSIGNED: Body mass index (BMI) continues to be a relevant factor in morbidity and resource use for elective open ventral hernia repair (VHR). A BMI of 32 serves as the threshold for significant increase in overall complications following open VHR, though this association is not observed in operations performed laparoscopically.