Scholarlink

Purpose <p>Identify the body mass index (BMI) threshold at which the risk of recurrence increases after hernia repair.</p> Methods <p>In this retrospective observational study, clinical data were collected from patients who underwent ventral hernia repair within a county-wide health system from to 2014–2020. Classification and Regression Tree (CART) analysis was used to determine the BMI threshold at which recurrence rate significantly increased. Bivariate and multivariable Cox regression analyses were used to determine the association of the identified threshold and other factors with recurrence. The Kaplan–Meyer analysis described the long-term recurrence risk based on the identified BMI threshold.</p> Results <p>478 patients with a median BMI of 32.5&#xa0;kg/m<sup>2</sup> (IQR = 29.9–36.3) were included. The recurrence rate was 14.4% over a median follow-up interval of 858.5 days (IQR = 138–1252). On CART analysis, BMI &gt; 33.67&#xa0;kg/m<sup>2</sup> was associated with significantly increased recurrence rates (23.6% vs. 8.4%, <i>p</i> &lt;.001). In the Cox regression analysis, cirrhosis (OR:4.205 [95% CI:1.608–10.995), <i>p</i> =.003], urgent or emergent repair (OR:2.111 [95% CI:1.029–4.332), <i>p</i> =.042], and BMI &gt; 33.67&#xa0;kg/m<sup>2</sup> [OR:2.179 (95% CI:1.284–3.669), <i>p</i> =.004] were found to be independently associated with recurrence. In addition, patients with a BMI &gt; 33.67&#xa0;kg/m2 had a statistically significant decrease in the six-year recurrence-free rate (<i>p</i> &lt;.001).</p> Conclusions <p>BMI &gt; 33.67&#xa0;kg/m<sup>2</sup> was the identified threshold at which hernia recurrence rate significantly increased in patients in a large county hospital system who underwent ventral hernia repair, and the risk continued for up to 6 years. A history of cirrhosis and urgent or emergent repair were also found to be independently associated with hernia recurrence.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Determining a BMI threshold for ventral hernia recurrence among a predominantly underrepresented minority population

  • 期刊论文

  • 发表日期：

    2025年5月17日

查看全文
  • James L. Cook,
  • Amanda C. Purdy,
  • Jessica K. Liu,
  • Chinelo Okafor,
  • Ashkan Moazzez,
  • Junko Ozao-Choy

摘要

Purpose

Identify the body mass index (BMI) threshold at which the risk of recurrence increases after hernia repair.

Methods

In this retrospective observational study, clinical data were collected from patients who underwent ventral hernia repair within a county-wide health system from to 2014–2020. Classification and Regression Tree (CART) analysis was used to determine the BMI threshold at which recurrence rate significantly increased. Bivariate and multivariable Cox regression analyses were used to determine the association of the identified threshold and other factors with recurrence. The Kaplan–Meyer analysis described the long-term recurrence risk based on the identified BMI threshold.

Results

478 patients with a median BMI of 32.5 kg/m2 (IQR = 29.9–36.3) were included. The recurrence rate was 14.4% over a median follow-up interval of 858.5 days (IQR = 138–1252). On CART analysis, BMI > 33.67 kg/m2 was associated with significantly increased recurrence rates (23.6% vs. 8.4%, p <.001). In the Cox regression analysis, cirrhosis (OR:4.205 [95% CI:1.608–10.995), p =.003], urgent or emergent repair (OR:2.111 [95% CI:1.029–4.332), p =.042], and BMI > 33.67 kg/m2 [OR:2.179 (95% CI:1.284–3.669), p =.004] were found to be independently associated with recurrence. In addition, patients with a BMI > 33.67 kg/m2 had a statistically significant decrease in the six-year recurrence-free rate (p <.001).

Conclusions

BMI > 33.67 kg/m2 was the identified threshold at which hernia recurrence rate significantly increased in patients in a large county hospital system who underwent ventral hernia repair, and the risk continued for up to 6 years. A history of cirrhosis and urgent or emergent repair were also found to be independently associated with hernia recurrence.