IS THE PATIENT AGE A RISK FACTOR FOR THE DEVELOPMENT OF INCISIONAL VENTRAL HERNIAS?

Abstract

Incisional hernia is a common complication following abdominal surgery. Numerous studies have addressed this issue. It has been reported that the incidence of incisional hernia after abdominal procedures is 10.1 % following laparotomy and 4.5 % following laparoscopy. We conducted a retrospective analysis of the medical records of 315 patients with incisional ventral hernias (study group) and 270 individuals with a history of abdominal surgery who did not develop incisional ventral hernias (comparison group). Among patients aged 19-30 years, there were 6 cases (1.9 %) of incisional ventral hernia, including 1 male and 5 females (OR 0.97, 95 % CI 0.11-8.44; χ² = 0.27, p = 0.606). In the 31-40-year age group, the male-to-female ratio was 1:11 (OR 0.43, 95 % CI 0.05-3.39; χ² = 0.19, p = 0.663). In patients aged 41-50 years, incisional ventral hernias were identified in 18 individuals (5.7 %), including 2 males and 16 females (OR 0.59, 95 % CI 0.13-2.64; χ² = 0.14, p = 0.705). Patients aged 51-60 years accounted for 19.4% of all cases and included 5 males and 56 females (OR 0.37, 95 % CI 0.14-0.98; χ² = 3.52, p = 0.061). The largest proportion of incisional ventral hernias (48.6%) was observed among patients aged 61-70 years, including 29 males and 124 females (OR 1.28, 95 % CI 0.71-2.31; χ² = 0.46, p = 0.496). Among patients aged 71-80 years, there were 65 cases (20.6 %), including 16 males and 49 females (OR 1.82, 95 % CI 0.94-3.53; χ² = 2.59, p = 0.107). Binary logistic regression analysis was performed to identify independent predictors. The results were expressed as odds ratios (ORs) with 95 % confidence intervals (95 % CIs). Variables that were statistically significant in the univariate analysis or considered clinically relevant were included in the regression model. Overall, the number of patients younger than 60 years was 1.51 times higher in the comparison group than in the study group (OR 2.69, 95 % CI 1.91-3.77; χ² = 32.48, p = 0.001). Analysis of patients aged 61-70 years demonstrated a significantly higher prevalence in the study group (OR 1.99, 95 % CI 1.42-2.78; χ² = 15.39, p = 0.001). A similar pattern was observed in patients older than 71 years (OR 1.69, 95 % CI 1.08-2.64; χ² = 4.92, p = 0.026). Beginning at the age of 60 years, the odds of developing an incisional hernia increased. Patients aged 61-70 years had a 50 % higher probability of developing an incisional hernia following abdominal surgery, whereas those aged 71-80 years had a 41% higher probability. As demonstrated by our analysis, advanced age is a multifactorial risk factor for the development of incisional hernias, reflecting both the overall decline in the body's regenerative capacity and the structural and functional changes of the abdominal wall. These findings should be taken into consideration when planning surgical intervention and selecting strategies for the prevention of incisional hernias. The increased risk of incisional hernia in older patients may be attributable to several factors that are less pronounced in younger age groups, including a higher burden of comorbidities, higher ASA scores, and a greater incidence of severe intraoperative and postoperative complications. In patients younger than 30 years, the probability of developing an incisional hernia was 67 % lower than in the other age categories.