Identification of risk factors for 30-day postoperative complications in patients undergoing primary ventral hernia repair

Background: Primary ventral hernia is a common condition. Surgical repair is associated with complications, but no clear predictive risk factors have been identified. The European Hernia Society classification offers a structured framework to describe hernias and to analyze postoperative complications. Given this structured nature, the European Hernia Society classification might prove useful for preoperative patient or treatment classification. The objective of this study was to investigate the European Hernia Society classification as a predictor for complications within 30 days after primary ventral hernia surgery.
Methods: A registry-based, prospective cohort study was performed, including all patients undergoing primary ventral hernia surgery between September 1, 2011 and February 29, 2016. Univariate analyses and multivariable logistic regression analysis were performed to identify risk factors for postoperative complications.
Results: A total of 2,374 patients were included, of whom 105 (4.4%) patients had ≥1 complications, either a wound, surgical, or medical complication. Factors associated with complications in univariate analyses (P < .10) and clinically relevant factors were included into the multivariable analyses. In the multivariable analyses, age, body mass index, and the duration of the operation were independent risk factors. The diameter of the hernia was not an independent risk factor.
Conclusion: Primary ventral hernia repair is associated with a 4.4% rate of complications. No correlation was found between the European Hernia Society classification and postoperative complications. Age, body mass index, and duration of the operation were correlated with postoperative complications. Therefore, age and body mass index should be used in the preoperative risk assessment.