Critical body mass index associated with increased ventral hernia recurrence rate

BACKGROUND: Body mass index (BMI) is a settled risk factor for ventral hernia repair complications. There is no agreement for a specific perfect BMI maximum value for elective hernia surgical repair. The goal of this study is to determine a BMI threshold that represents a risk for ventral hernia recurrence after repair. MATERIALS AND METHODS: This is a retrospective single-center study of electronic medical records for patients with repair of ventral hernia from June 2017 to May 2023. The primary outcome of the study is to measure the hernia recurrence. The decision regression trees method was utilized to set the BMI threshold that is associated with a significant increase in the hernia recurrence risk. Bivariate and multivariate analysis was applied to prove the BMI threshold and to assess other factors related to recurrence. RESULTS: In total, 110 patients were included, 8.2% of them suffered from ventral hernia recurrence. The analysis defined BMI 38.7 kg/m2 as the critical value for the recurrence of hernia. Patients with liver disease were more likely to have hernia recurrence (11.1% vs. 0%, P = 0.006), irreducible hernias (66.7% vs. 32.6%, P = 0.002), emergency surgery (66.6% vs. 21.7%, P < 0.001), and BMI >38.7 kg/m2 (77.8% vs. 26.7%, P < 0.001). CONCLUSION: We found that a BMI of more than 38.7 kg/m2 had a significant increase in the risk of recurrence in ventral hernia patients. This shows the importance of defining a BMI threshold in ventral hernia patients for repair.