Nationwide prospective study on readmission after umbilical or epigastric hernia repair

Abstract

Purpose: The primary aim of the present study was to investigate risk factors for readmission after elective umbilical and epigastric hernia repair and secondarily to evaluate causes for readmission.

Methods: All patients with elective umbilical or epigastric hernias registered in The Danish Hernia Database during January 2007-January 2011 were included. A 100 % 30-day follow-up was obtained by merging with administrative data from The Danish National Patient Register.

Results: A total of 6,783 umbilical and epigastric hernia repairs were included (open = 5,634; laparoscopic = 1,149). Readmissions caused by surgical and medical complications related to the hernia repair were observed in 3.6 and 1.5 % of patients, respectively. Surgical complications were mainly due to pain and wound complications, whereas medical complications were mainly cardiovascular, pulmonary, and renal complications. There were no significant differences in surgical or medical complication rates and in risk factors for readmission between open and laparoscopic repair, P ≥ 0.229. After open repair, independent risk factors for readmission were umbilical hernia repair (vs epigastric repair) (OR = 1.5, 95 % CI 1.1-2.1), hernia defects >2 cm (OR = 1.7, 95 % CI 1.2-2.5), mesh reinforcement (OR = 1.3, 95 % CI 1.0-1.7), and tacked mesh fixation (OR = 2.6, 95 % CI 1.1-6.0). After laparoscopic repair, female gender was the only independent risk factor for readmission (OR = 1.7, 95 % CI 1.1-2.7).

Conclusion: The risk for 30-day readmission after umbilical or epigastric hernia repairs was mainly because of surgical complications. Open mesh repair reduced the risk for readmission in open repairs; no specific approach was found to reduce readmission after laparoscopic repair.