Incidence and risk factors for incisional hernia and recurrence: retrospective analysis of the French national database
Résumé
Purpose
To determine the rate of incisional hernia (IH) repair and risk factors for IH repair after laparotomy.
Methods
This population‐based study used data extracted from the French (PMSI) database. All patients who had undergone a laparotomy in 2010, their hospital visits from 2010‒2015, and patients who underwent a first IH repair in 2013 were included. Risk factors identified previously included: age, gender, high blood pressure (HBP), obesity, diabetes and chronic obstructive pulmonary disease (COPD).
Results
Among the 431 619 patients who underwent a laparotomy in 2010, 5% underwent IH repair between 2010 and 2015. A high‐risk list of the most frequent surgical procedures (>100) with a significant risk of IH repair (>10% at 5 years) was established including 71 863 patients (17%, 65 procedures). Overall IH repair rate from the list was 17%. Gastrointestinal (GI) surgery represented 89% of procedures with the majority of patients (72%) undergoing lower GI tract surgery. IH repair rate was 56% at 1 year and 79% at 2 years. Risk factors for IH repair included obesity (31% vs. 15%, p<0.001), COPD (20% vs. 15%), HBP (19% vs. 15%) and diabetes (19% vs. 16%). Even for recurrence after IH repair, obesity was the main risk factor (19% vs. 13%, p<0.001)
Conclusion
From the PMSI database, the real rate of IH repair after laparotomy was 5%, increasing to 17% after digestive surgery. Obesity was the main risk factor with an IH repair rate of 31% after digestive surgery. Because of the important medico‐economic consequences, prevention of IH after laparotomy in high‐risk patients should be considered.
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