Predictors of laparoscopic versus open inguinal hernia repair
Background Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open I...
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| Veröffentlicht in: | Surgical endoscopy 2019-08, Vol.33 (8), p.2612-2619 |
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| creator | Pavlosky, K. Keano Vossler, John D. Murayama, Sarah M. Moucharite, Marilyn A. Murayama, Kenric M. Mikami, Dean J. |
| description | Background
Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open IHR.
Methods
We conducted a retrospective analysis of 342,814 IHRs (241,669 open; 101,145 laparoscopic) performed in adults (age ≥ 18) from 2010 to 2015 using the Premier Hospital Database. Multivariate logistic regression was used to estimate the adjusted odds ratio of an IHR being laparoscopic versus open with respect to several demographic variables.
Results
The odds of an IHR being laparoscopic increased from 2010 to 2015. A laparoscopic procedure was more likely in patients who were |
| doi_str_mv | 10.1007/s00464-018-6557-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2127201183</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2126732575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-64bd4a7e15b57444a45a030d2b2f70e47d2be93ce043c8ac65d4b516eb88cc763</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMo7rr6A7xIwYuXaL7THjzI4hcIetBzSNPpmqXb1mQr-O_N2lVB8JSQefLOzIPQMSXnlBB9EQkRSmBCc6yk1FjtoCkVnGHGaL6LpqTgBDNdiAk6iHFJEl5QuY8mnHAtdF5M0eVTgMq7dRdi1tVZY3sbuui63rvsHUIc0nMPbebbxeBb22SvEFpvswC99eEQ7dW2iXC0PWfo5eb6eX6HHx5v7-dXD9hxzdZYibISVgOVpdRCCCukJZxUrGS1JiB0ukHBHRDBXW6dkpUoJVVQ5rlzWvEZOhtz-9C9DRDXZuWjg6axLXRDNIwyzQilOU_o6R902Q0hTf5FKc2Z1DJRdKRc2jYGqE0f_MqGD0OJ2bg1o1uT3JqNW7MZ4mSbPJQrqH5-fMtMABuBmErtAsJv6_9TPwGE9oM3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2126732575</pqid></control><display><type>article</type><title>Predictors of laparoscopic versus open inguinal hernia repair</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Pavlosky, K. Keano ; Vossler, John D. ; Murayama, Sarah M. ; Moucharite, Marilyn A. ; Murayama, Kenric M. ; Mikami, Dean J.</creator><creatorcontrib>Pavlosky, K. Keano ; Vossler, John D. ; Murayama, Sarah M. ; Moucharite, Marilyn A. ; Murayama, Kenric M. ; Mikami, Dean J.</creatorcontrib><description><![CDATA[Background
Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open IHR.
Methods
We conducted a retrospective analysis of 342,814 IHRs (241,669 open; 101,145 laparoscopic) performed in adults (age ≥ 18) from 2010 to 2015 using the Premier Hospital Database. Multivariate logistic regression was used to estimate the adjusted odds ratio of an IHR being laparoscopic versus open with respect to several demographic variables.
Results
The odds of an IHR being laparoscopic increased from 2010 to 2015. A laparoscopic procedure was more likely in patients who were < age 65 (OR 1.29, CI 1.24–1.31,
p
< 0.0001), male (OR 1.31, CI 1.27–1.34,
p
< 0.0001), privately insured (OR 1.36, CI 1.33–1.40,
p
< 0.0001), and neither white, black, nor Hispanic (OR 1.11, CI 1.09–1.14,
p
< 0.0001). The likelihood of a procedure being laparoscopic decreased 13% with each one-unit increase in Charlson comorbidity index value (OR 0.88, CI 0.87–0.89,
p
< 0.0001). Surgeons were more likely to perform a laparoscopic procedure if they had larger annual IHR caseloads (≥ 45/year; OR 1.57, CI 1.53–1.60,
p
< 0.0001), and operated at large hospitals (> 500 beds; OR 1.36, CI 1.33–1.39,
p
< 0.0001) in New England (OR 2.38, CI 2.29–2.47,
p
< 0.0001). Non-predictors of a laparoscopic procedure included urban/rural hospital location (OR 1.02, CI 0.10–1.05,
p
= 0.06) and hospital teaching status (OR 1.01, CI 0.99–1.03,
p
= 0.2084).
Conclusions
Use of laparoscopic IHR is increasing. Patient age, gender, race, and insurance type, as well as surgeon annual volume, hospital size, and hospital region were predictors of a laparoscopic procedure. Further studies are needed to explain and remedy underlying differences impacting these predictors.]]></description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6557-6</identifier><identifier>PMID: 30374789</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Age Factors ; Aged ; Databases, Factual ; Female ; Gastroenterology ; Gynecology ; Health Facility Size ; Hepatology ; Hernia, Inguinal - surgery ; Hernias ; Herniorrhaphy - methods ; Herniorrhaphy - statistics & numerical data ; Hospitals, Rural ; Hospitals, Urban ; Humans ; Insurance Coverage ; Laparoscopy ; Laparoscopy - methods ; Laparoscopy - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Proctology ; Race Factors ; Retrospective Studies ; Sex Factors ; Surgeons ; Surgery ; United States</subject><ispartof>Surgical endoscopy, 2019-08, Vol.33 (8), p.2612-2619</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-64bd4a7e15b57444a45a030d2b2f70e47d2be93ce043c8ac65d4b516eb88cc763</citedby><cites>FETCH-LOGICAL-c372t-64bd4a7e15b57444a45a030d2b2f70e47d2be93ce043c8ac65d4b516eb88cc763</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/s00464-018-6557-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6557-6$$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/30374789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pavlosky, K. Keano</creatorcontrib><creatorcontrib>Vossler, John D.</creatorcontrib><creatorcontrib>Murayama, Sarah M.</creatorcontrib><creatorcontrib>Moucharite, Marilyn A.</creatorcontrib><creatorcontrib>Murayama, Kenric M.</creatorcontrib><creatorcontrib>Mikami, Dean J.</creatorcontrib><title>Predictors of laparoscopic versus open inguinal hernia repair</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description><![CDATA[Background
Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open IHR.
Methods
We conducted a retrospective analysis of 342,814 IHRs (241,669 open; 101,145 laparoscopic) performed in adults (age ≥ 18) from 2010 to 2015 using the Premier Hospital Database. Multivariate logistic regression was used to estimate the adjusted odds ratio of an IHR being laparoscopic versus open with respect to several demographic variables.
Results
The odds of an IHR being laparoscopic increased from 2010 to 2015. A laparoscopic procedure was more likely in patients who were < age 65 (OR 1.29, CI 1.24–1.31,
p
< 0.0001), male (OR 1.31, CI 1.27–1.34,
p
< 0.0001), privately insured (OR 1.36, CI 1.33–1.40,
p
< 0.0001), and neither white, black, nor Hispanic (OR 1.11, CI 1.09–1.14,
p
< 0.0001). The likelihood of a procedure being laparoscopic decreased 13% with each one-unit increase in Charlson comorbidity index value (OR 0.88, CI 0.87–0.89,
p
< 0.0001). Surgeons were more likely to perform a laparoscopic procedure if they had larger annual IHR caseloads (≥ 45/year; OR 1.57, CI 1.53–1.60,
p
< 0.0001), and operated at large hospitals (> 500 beds; OR 1.36, CI 1.33–1.39,
p
< 0.0001) in New England (OR 2.38, CI 2.29–2.47,
p
< 0.0001). Non-predictors of a laparoscopic procedure included urban/rural hospital location (OR 1.02, CI 0.10–1.05,
p
= 0.06) and hospital teaching status (OR 1.01, CI 0.99–1.03,
p
= 0.2084).
Conclusions
Use of laparoscopic IHR is increasing. Patient age, gender, race, and insurance type, as well as surgeon annual volume, hospital size, and hospital region were predictors of a laparoscopic procedure. Further studies are needed to explain and remedy underlying differences impacting these predictors.]]></description><subject>Abdominal Surgery</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Health Facility Size</subject><subject>Hepatology</subject><subject>Hernia, Inguinal - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - methods</subject><subject>Herniorrhaphy - statistics & numerical data</subject><subject>Hospitals, Rural</subject><subject>Hospitals, Urban</subject><subject>Humans</subject><subject>Insurance Coverage</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Laparoscopy - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Proctology</subject><subject>Race Factors</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>United States</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1LxDAQhoMo7rr6A7xIwYuXaL7THjzI4hcIetBzSNPpmqXb1mQr-O_N2lVB8JSQefLOzIPQMSXnlBB9EQkRSmBCc6yk1FjtoCkVnGHGaL6LpqTgBDNdiAk6iHFJEl5QuY8mnHAtdF5M0eVTgMq7dRdi1tVZY3sbuui63rvsHUIc0nMPbebbxeBb22SvEFpvswC99eEQ7dW2iXC0PWfo5eb6eX6HHx5v7-dXD9hxzdZYibISVgOVpdRCCCukJZxUrGS1JiB0ukHBHRDBXW6dkpUoJVVQ5rlzWvEZOhtz-9C9DRDXZuWjg6axLXRDNIwyzQilOU_o6R902Q0hTf5FKc2Z1DJRdKRc2jYGqE0f_MqGD0OJ2bg1o1uT3JqNW7MZ4mSbPJQrqH5-fMtMABuBmErtAsJv6_9TPwGE9oM3</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Pavlosky, K. Keano</creator><creator>Vossler, John D.</creator><creator>Murayama, Sarah M.</creator><creator>Moucharite, Marilyn A.</creator><creator>Murayama, Kenric M.</creator><creator>Mikami, Dean J.</creator><general>Springer US</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>7RV</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>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20190801</creationdate><title>Predictors of laparoscopic versus open inguinal hernia repair</title><author>Pavlosky, K. Keano ; Vossler, John D. ; Murayama, Sarah M. ; Moucharite, Marilyn A. ; Murayama, Kenric M. ; Mikami, Dean J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-64bd4a7e15b57444a45a030d2b2f70e47d2be93ce043c8ac65d4b516eb88cc763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Health Facility Size</topic><topic>Hepatology</topic><topic>Hernia, Inguinal - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - methods</topic><topic>Herniorrhaphy - statistics & numerical data</topic><topic>Hospitals, Rural</topic><topic>Hospitals, Urban</topic><topic>Humans</topic><topic>Insurance Coverage</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Laparoscopy - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Proctology</topic><topic>Race Factors</topic><topic>Retrospective Studies</topic><topic>Sex Factors</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pavlosky, K. Keano</creatorcontrib><creatorcontrib>Vossler, John D.</creatorcontrib><creatorcontrib>Murayama, Sarah M.</creatorcontrib><creatorcontrib>Moucharite, Marilyn A.</creatorcontrib><creatorcontrib>Murayama, Kenric M.</creatorcontrib><creatorcontrib>Mikami, Dean J.</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>Nursing & Allied Health Database</collection><collection>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 Edition)</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>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pavlosky, K. Keano</au><au>Vossler, John D.</au><au>Murayama, Sarah M.</au><au>Moucharite, Marilyn A.</au><au>Murayama, Kenric M.</au><au>Mikami, Dean J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of laparoscopic versus open inguinal hernia repair</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>33</volume><issue>8</issue><spage>2612</spage><epage>2619</epage><pages>2612-2619</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract><![CDATA[Background
Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open IHR.
Methods
We conducted a retrospective analysis of 342,814 IHRs (241,669 open; 101,145 laparoscopic) performed in adults (age ≥ 18) from 2010 to 2015 using the Premier Hospital Database. Multivariate logistic regression was used to estimate the adjusted odds ratio of an IHR being laparoscopic versus open with respect to several demographic variables.
Results
The odds of an IHR being laparoscopic increased from 2010 to 2015. A laparoscopic procedure was more likely in patients who were < age 65 (OR 1.29, CI 1.24–1.31,
p
< 0.0001), male (OR 1.31, CI 1.27–1.34,
p
< 0.0001), privately insured (OR 1.36, CI 1.33–1.40,
p
< 0.0001), and neither white, black, nor Hispanic (OR 1.11, CI 1.09–1.14,
p
< 0.0001). The likelihood of a procedure being laparoscopic decreased 13% with each one-unit increase in Charlson comorbidity index value (OR 0.88, CI 0.87–0.89,
p
< 0.0001). Surgeons were more likely to perform a laparoscopic procedure if they had larger annual IHR caseloads (≥ 45/year; OR 1.57, CI 1.53–1.60,
p
< 0.0001), and operated at large hospitals (> 500 beds; OR 1.36, CI 1.33–1.39,
p
< 0.0001) in New England (OR 2.38, CI 2.29–2.47,
p
< 0.0001). Non-predictors of a laparoscopic procedure included urban/rural hospital location (OR 1.02, CI 0.10–1.05,
p
= 0.06) and hospital teaching status (OR 1.01, CI 0.99–1.03,
p
= 0.2084).
Conclusions
Use of laparoscopic IHR is increasing. Patient age, gender, race, and insurance type, as well as surgeon annual volume, hospital size, and hospital region were predictors of a laparoscopic procedure. Further studies are needed to explain and remedy underlying differences impacting these predictors.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>30374789</pmid><doi>10.1007/s00464-018-6557-6</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Age Factors Aged Databases, Factual Female Gastroenterology Gynecology Health Facility Size Hepatology Hernia, Inguinal - surgery Hernias Herniorrhaphy - methods Herniorrhaphy - statistics & numerical data Hospitals, Rural Hospitals, Urban Humans Insurance Coverage Laparoscopy Laparoscopy - methods Laparoscopy - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Proctology Race Factors Retrospective Studies Sex Factors Surgeons Surgery United States |
| title | Predictors of laparoscopic versus open inguinal hernia repair |
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