Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database
Purpose Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Qualit...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2017-06, Vol.21 (3), p.323-333 |
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| creator | Chung, P. J. Lee, J. S. Tam, S. Schwartzman, A. Bernstein, M. O. Dresner, L. Alfonso, A. Sugiyama, G. |
| description | Purpose
Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database.
Methods
A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created.
Results
There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05–16.75), age (OR 5.52, 95 % CI 3.48–8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08–11.92), presence of ascites (OR 3.16, 95 % CI 1.64–6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22–1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02–1.45). The C-statistic for the risk model was 0.858.
Conclusion
We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability. |
| doi_str_mv | 10.1007/s10029-016-1538-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859740748</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1899818468</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-23787c7f3155294dc204fefed584656c6ff3cd4f05c42be4adab9c28af479b433</originalsourceid><addsrcrecordid>eNp1kc2O1iAUhhujcX70AtwYEjduqkBpocvJF38mmegYdd2c0kOHCS2fQGfSa_PmpOlojIkbIIfnvC-ctyheMPqGUSrfxrzytqSsKVldqXJ9VJwyLlTZcioeb-emLkVLm5PiLMZbSqkSjXpanHDZVJIpeVr8vA44WJ3sPJKKlgOs5Ohj8kcMkOwdksmHBM6mlRgfCE4YRpwTgTlhsLkC_eAnO4Mj9-AcucEwWyABj2BDJEvchNMNkovcaTXM5OCdwxGJN-TrksX8HMmn7OU3ja2SKUe-LLvp5XQM_i7bZs_r4McAExkgQQ8RnxVPDLiIzx_28-L7-3ffDh_Lq88fLg8XV6WuJE8lr6SSWpqK1TVvxaDzcAwaHOo8jbrRjTGVHoShtRa8RwED9K3mCoyQbS-q6rx4vevmp_xYMKZuslGjczCjX2LHVN1KQaVQGX31D3rrl5B_tlFtq9gWQKbYTungYwxoumOwE4S1Y7Tbku32ZLucbLcl26255-WD8tJPOPzp-B1lBvgOxHw1jxj-sv6v6i82ObOr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1899818468</pqid></control><display><type>article</type><title>Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database</title><source>MEDLINE</source><source>SpringerLink_现刊</source><creator>Chung, P. J. ; Lee, J. S. ; Tam, S. ; Schwartzman, A. ; Bernstein, M. O. ; Dresner, L. ; Alfonso, A. ; Sugiyama, G.</creator><creatorcontrib>Chung, P. J. ; Lee, J. S. ; Tam, S. ; Schwartzman, A. ; Bernstein, M. O. ; Dresner, L. ; Alfonso, A. ; Sugiyama, G.</creatorcontrib><description>Purpose
Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database.
Methods
A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created.
Results
There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05–16.75), age (OR 5.52, 95 % CI 3.48–8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08–11.92), presence of ascites (OR 3.16, 95 % CI 1.64–6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22–1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02–1.45). The C-statistic for the risk model was 0.858.
Conclusion
We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-016-1538-y</identifier><identifier>PMID: 27637187</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdomen ; Abdominal Surgery ; Abdominal wall ; Abdominal Wall - surgery ; Adult ; Age ; Aged ; Ascites ; Congestive heart failure ; Data processing ; Databases, Factual ; Female ; Femur ; Health risk assessment ; Hernia ; Hernia, Ventral - surgery ; Hernias ; Herniorrhaphy - adverse effects ; Herniorrhaphy - mortality ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Nitrogen ; Original Article ; Prognosis ; Quality control ; Quality Improvement ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Statistical analysis ; Surgeons ; Surgery ; Terminology ; United States ; Urea</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2017-06, Vol.21 (3), p.323-333</ispartof><rights>Springer-Verlag France 2016</rights><rights>Hernia is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-23787c7f3155294dc204fefed584656c6ff3cd4f05c42be4adab9c28af479b433</citedby><cites>FETCH-LOGICAL-c372t-23787c7f3155294dc204fefed584656c6ff3cd4f05c42be4adab9c28af479b433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-016-1538-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-016-1538-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27637187$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, P. J.</creatorcontrib><creatorcontrib>Lee, J. S.</creatorcontrib><creatorcontrib>Tam, S.</creatorcontrib><creatorcontrib>Schwartzman, A.</creatorcontrib><creatorcontrib>Bernstein, M. O.</creatorcontrib><creatorcontrib>Dresner, L.</creatorcontrib><creatorcontrib>Alfonso, A.</creatorcontrib><creatorcontrib>Sugiyama, G.</creatorcontrib><title>Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database.
Methods
A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created.
Results
There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05–16.75), age (OR 5.52, 95 % CI 3.48–8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08–11.92), presence of ascites (OR 3.16, 95 % CI 1.64–6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22–1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02–1.45). The C-statistic for the risk model was 0.858.
Conclusion
We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Abdominal wall</subject><subject>Abdominal Wall - surgery</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Ascites</subject><subject>Congestive heart failure</subject><subject>Data processing</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Femur</subject><subject>Health risk assessment</subject><subject>Hernia</subject><subject>Hernia, Ventral - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Herniorrhaphy - mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nitrogen</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Quality control</subject><subject>Quality Improvement</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Terminology</subject><subject>United States</subject><subject>Urea</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc2O1iAUhhujcX70AtwYEjduqkBpocvJF38mmegYdd2c0kOHCS2fQGfSa_PmpOlojIkbIIfnvC-ctyheMPqGUSrfxrzytqSsKVldqXJ9VJwyLlTZcioeb-emLkVLm5PiLMZbSqkSjXpanHDZVJIpeVr8vA44WJ3sPJKKlgOs5Ohj8kcMkOwdksmHBM6mlRgfCE4YRpwTgTlhsLkC_eAnO4Mj9-AcucEwWyABj2BDJEvchNMNkovcaTXM5OCdwxGJN-TrksX8HMmn7OU3ja2SKUe-LLvp5XQM_i7bZs_r4McAExkgQQ8RnxVPDLiIzx_28-L7-3ffDh_Lq88fLg8XV6WuJE8lr6SSWpqK1TVvxaDzcAwaHOo8jbrRjTGVHoShtRa8RwED9K3mCoyQbS-q6rx4vevmp_xYMKZuslGjczCjX2LHVN1KQaVQGX31D3rrl5B_tlFtq9gWQKbYTungYwxoumOwE4S1Y7Tbku32ZLucbLcl26255-WD8tJPOPzp-B1lBvgOxHw1jxj-sv6v6i82ObOr</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Chung, P. J.</creator><creator>Lee, J. S.</creator><creator>Tam, S.</creator><creator>Schwartzman, A.</creator><creator>Bernstein, M. O.</creator><creator>Dresner, L.</creator><creator>Alfonso, A.</creator><creator>Sugiyama, G.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database</title><author>Chung, P. J. ; Lee, J. S. ; Tam, S. ; Schwartzman, A. ; Bernstein, M. O. ; Dresner, L. ; Alfonso, A. ; Sugiyama, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-23787c7f3155294dc204fefed584656c6ff3cd4f05c42be4adab9c28af479b433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Abdominal wall</topic><topic>Abdominal Wall - surgery</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Ascites</topic><topic>Congestive heart failure</topic><topic>Data processing</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Femur</topic><topic>Health risk assessment</topic><topic>Hernia</topic><topic>Hernia, Ventral - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Herniorrhaphy - mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nitrogen</topic><topic>Original Article</topic><topic>Prognosis</topic><topic>Quality control</topic><topic>Quality Improvement</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Terminology</topic><topic>United States</topic><topic>Urea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chung, P. J.</creatorcontrib><creatorcontrib>Lee, J. S.</creatorcontrib><creatorcontrib>Tam, S.</creatorcontrib><creatorcontrib>Schwartzman, A.</creatorcontrib><creatorcontrib>Bernstein, M. O.</creatorcontrib><creatorcontrib>Dresner, L.</creatorcontrib><creatorcontrib>Alfonso, A.</creatorcontrib><creatorcontrib>Sugiyama, G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chung, P. J.</au><au>Lee, J. S.</au><au>Tam, S.</au><au>Schwartzman, A.</au><au>Bernstein, M. O.</au><au>Dresner, L.</au><au>Alfonso, A.</au><au>Sugiyama, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>21</volume><issue>3</issue><spage>323</spage><epage>333</epage><pages>323-333</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose
Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database.
Methods
A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created.
Results
There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05–16.75), age (OR 5.52, 95 % CI 3.48–8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08–11.92), presence of ascites (OR 3.16, 95 % CI 1.64–6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22–1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02–1.45). The C-statistic for the risk model was 0.858.
Conclusion
We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>27637187</pmid><doi>10.1007/s10029-016-1538-y</doi><tpages>11</tpages></addata></record> |
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| subjects | Abdomen Abdominal Surgery Abdominal wall Abdominal Wall - surgery Adult Age Aged Ascites Congestive heart failure Data processing Databases, Factual Female Femur Health risk assessment Hernia Hernia, Ventral - surgery Hernias Herniorrhaphy - adverse effects Herniorrhaphy - mortality Humans Male Medicine Medicine & Public Health Middle Aged Mortality Nitrogen Original Article Prognosis Quality control Quality Improvement Retrospective Studies Risk Assessment Risk Factors Statistical analysis Surgeons Surgery Terminology United States Urea |
| title | Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database |
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