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. 2022 Oct;26(5):1355-1368.
doi: 10.1007/s10029-022-02644-4. Epub 2022 Aug 25.

National epidemiologic trends (2008-2018) in the United States for the incidence and expenditures associated with incisional hernia in relation to abdominal surgery

A J Rios-Diaz  1   2 , M P Morris  1 , A N Christopher  1   2 , V Patel  1 , R B Broach  1 , B T Heniford  3 , J Y Hsu  4 , J P Fischer  5
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National epidemiologic trends (2008-2018) in the United States for the incidence and expenditures associated with incisional hernia in relation to abdominal surgery

A J Rios-Diaz et al. Hernia. 2022 Oct.

Abstract

Purpose: It is unknown whether the trend of rising incisional hernia (IH) repair (IHR) incidence and costs until 2011 currently persists. We aimed to evaluate how the IHR procedure incidence, cost and patient risk-profile have changed over the last decade relative to all abdominal surgeries (AS).

Methods: Repeated cross-sectional analysis of 38,512,737 patients undergoing inpatient 4AS including IHR within the 2008-2018 National Inpatient Sample. Yearly incidence (procedures/1,000,000 people [PMP]), hospital costs, surgical and patient characteristics were compared between IHR and AS using generalized linear and multinomial regression.

Results: Between 2008-2018, 3.1% of AS were IHR (1,200,568/38,512,737). There was a steeper decrease in the incidence of AS (356.5 PMP/year) compared to IHR procedures (12.0 PMP/year) which resulted in the IHR burden relative to AS (2008-2018: 12,576.3 to 9,113.4 PMP; trend difference P < 0.01). National costs averaged $47.9 and 1.7 billion/year for AS and IHR, respectively. From 2008-2018, procedure costs increased significantly for AS (68.2%) and IHR (74.6%; trends P < 0.01). Open IHR downtrended (42.2%), whereas laparoscopic (511.1%) and robotic (19,301%) uptrended significantly (trends P < 0.01). For both AS and IHR, the proportion of older (65-85y), Black and Hispanic, publicly-insured, and low-income patients, with higher comorbidity burden, undergoing elective procedures at small- and medium-sized hospitals uptrended significantly (all P < 0.01).

Conclusion: IH persists as a healthcare burden as demonstrated by the increased proportion of IHR relative to all AS, disproportionate presence of high-risk patients that undergo these procedures, and increased costs. Targeted efforts for IH prevention have the potential of decreasing $17 M/year in costs for every 1% reduction.

Keywords: Abdominal surgery; Epidemiology; Healthcare burden; Hospital costs; Incisional hernia; Nationwide inpatient sample.

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References

    1. Zhu F, Li Y, Guo Z et al (2020) Nomogram to predict postoperative intra-abdominal septic complications after bowel resection and primary anastomosis for crohn’s disease. Dis Colon Rectum 63(5):629–638 - PubMed - DOI
    1. Andalib A, Alamri H, Almuhanna Y, Bouchard P, Demyttenaere S, Court O (2020) Short-term outcomes of revisional surgery after sleeve gastrectomy: a comparative analysis of re-sleeve, Roux en-Y gastric bypass, duodenal switch (Roux en-Y and single-anastomosis). Surg Endosc 35(4644):4652
    1. Kao AM, Cetrulo LN, Baimas-George MR et al (2019) Outcomes of open abdomen versus primary closure following emergent laparotomy for suspected secondary peritonitis: a propensity-matched analysis. J Trauma Acute Care Surg 87(3):623–629 - PubMed - DOI
    1. Gogna S, Latifi R, Choi J et al (2020) Predictors of 30- and 90-day readmissions after complex abdominal wall reconstruction with biological mesh: a longitudinal study of 232 patients. World J Surg 44(11):3720–3728 - PubMed - DOI
    1. Gogna S, Latifi R, Choi J et al (2021) Early versus delayed complex abdominal wall reconstruction with biologic mesh following damage-control surgery. J Trauma Acute Care Surg 90(3):527–534 - PubMed - DOI

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