Background: We sought to explore the impact of sex, race, and insurance status on operative management of incisional hernias.
Methods: A retrospective cohort study was conducted to explore adult patients diagnosed with an incisional hernia. Adjusted odds for non-operative versus operative management and time to repair were queried.
Results: Of the 29,475 patients with an incisional hernia, 20,767 (70.5%) underwent non-operative management. In relation to private insurance, Medicaid (aOR 1.40, 95% CI 1.27-1.54), Medicare (aOR 1.53, 95% CI 1.42-1.65), and uninsured status (aOR 1.99, 95% CI 1.71-2.36) were independently associated with non-operative management. African American race (aOR 1.30, 95% CI 1.17-1.47) was associated with non-operative management while female sex (aOR 0.81, 95% CI 0.77-0.86) was predictive of elective repair. For patients who underwent elective repair, both Medicare (aOR 1.40, 95% CI 1.18-1.66) and Medicaid (aOR 1.49, 95% CI 1.29-1.71) insurance, but not race, were predictive of delayed repair (>90 days after diagnosis).
Conclusions: Sex, race, and insurance status influence incisional hernia management. Development of evidence-based management guidelines may help to ensure equitable care.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjsurg.2023.04.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Clinical Impact of the Introduction of a Robot-Assisted Program in a Specialized Hernia Center: A Propensity Score Matched Cohort Study on Short-Term Outcomes.
World J Surg
January 2025
Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark.
Background: The role of robot-assisted approach in hernia surgery remains controversial due to high procedural costs and the proposed equal outcomes compared with open surgery. In this study, we report the 30-day results of the introduction of robot-assisted approach in a specialized regional ventral hernia repair center.
Methods: This was a retrospective single-center cohort study including patients undergoing either robot-assisted or open ventral hernia repair from 2017 to 2022.
Defect width as a percentage of transverse abdominal diameter: An index to predict the requirement for component separation in incisional hernia repair.
Heliyon
January 2025
Department of Hernia and Abdominal Wall Surgery, Hangzhou First People's Hospital, Hangzhou, 310006, PR China.
Purpose: Preoperative decision making prior to incisional hernia repair brings benefits but also presents challenges. Defect width (DW) is the key index in hernia staging but does not precisely indicate the requirement for component separation (CS). DW as a percentage of transverse abdominal diameter (TAD) determined by CT imaging was investigated for its capacity to indicate the necessity of CS for successful defect closure under physiological tension.
View Article and Find Full Text PDF[Guidelines for diagnosis and treatment of abdominal wall incision hernia (2024 edition)].
Zhonghua Wai Ke Za Zhi
January 2025
Incisional hernia is a type of iatrogenic disease, and its clinical treatment is complicated. In recent years, there have been new advances in the diagnosis, surgical methods, and materials science of incisional hernias. On the basis of the , more than 70 experts and scholars over the country have discussed the consultation and modified the issues such as complex abdominal wall conditions, loss of domain, principles of incisional hernia treatment, techniques of abdominal wall hernia defects closure, perioperative management, and follow-up in this new edition, combined with evidence-based medical evaluation standards.
View Article and Find Full Text PDFAssessment of the European Hernia Society Classification of Ventral Hernias and Clinical Outcomes.
HCA Healthc J Med
December 2024
HCA Houston Healthcare Kingwood, Kingwood, TX.
Background: Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size.
View Article and Find Full Text PDFAnterior component separation techniques: is it necessary to preserve the perforators? a systematic review and meta-analysis.
Hernia
January 2025
Department of Surgery, Montefiore Medical Center, NY, USA.
Background: Anterior component separation (ACS), or Ramirez component separation technique, is an established technique still used by surgeons to repair a ventral hernia. Compared with other ventral hernia repair techniques, recent studies about ACS show more postoperative complications like wound breakdown, wound infection, hematoma, skin necrosis, seroma, and recurrence. Our study aims to compare the ACS technique with the preservation perforator technique and verify if the perforator preservation technique can decrease postoperative complications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!