The following is a summary of “Distressed community index as a predictor of presentation and postoperative outcomes in ventral hernia repair,” published in the November 2023 issue of Surgery by Maskal, et al.
For a study, researchers assessed the influence of socioeconomic status on the presentation, management, and outcomes of ventral hernias.
The Abdominal Core Health Quality Collaborative database was utilized to identify adult patients undergoing ventral hernia repair. Socioeconomic quintiles were determined using the Distressed Community Index (DCI), categorizing patients as prosperous (0–20), comfortable (21–40), mid-tier (41–60), at-risk (61–80), or distressed (81–100). Outcomes encompassed presenting symptoms, urgency, operative details, 30-day outcomes, and one-year hernia recurrence rates. Multivariable regression analysis was performed to assess 30-day wound complications.
Among 39,494 identified subjects, 32,471 had accessible zip codes (82.2%). The distressed group exhibited more frequent urgent presentation (3.6% vs. 2.3%) and contaminated cases (0.83% vs. 2.06%) compared to the prosperous group (P < 0.001). Increasing DCI correlated with higher rates of readmission (distressed: 4.7% vs. prosperous: 2.9%, P < 0.001) and reoperation (distressed: 1.8% vs. prosperous: 0.92%, P < 0.001). Wound complications were independently associated with escalating DCI (P < 0.05). Clinical recurrence rates at one year were comparable (distressed: 10.4% vs. prosperous: 8.6%, P = 0.54).
Disparities exist in ventral hernia repair’s presentation and perioperative outcomes, emphasizing the need to enhance access to elective surgery and improve postoperative wound care.
Source: americanjournalofsurgery.com/article/S0002-9610(23)00267-2/fulltext
