Patient-related risk factors for the development of post-operative hernias

Abstract

Objective. To identify the most significant patient-related risk factors for the development of hernias following emergency and elective surgical procedures.Materials and methods. An analysis was carried out of the medical records of 315 patients with post-operative ventral hernias (main group) and 270 patients who did not develop ventral hernias following surgical procedures (control group). The time to onset of post-operative hernias ranged from 3 to 60 months. An M1 defect was present in 70 (22.2%) patients, an M2 defect in 153 (48.6%), an M3 defect in 31 (9.8%), an M4 defect in 17 (5.4%), and a lateral defect in 44 (14.0%) patients. A W1 defect (less than 4 cm) was observed in 113 (35.9%) patients, a W2 defect (4–10 cm) in 177 (56.2%) and a W3 defect (more than 10 cm) in 25 (7.9%) patients.Results. According to the analysis, significant patient-related risk factors for the development of a post-operative hernia were: age 61–70 years: odds ratio 1.99 (1.42–2.78), p = 0.001; age 71–80 years: odds ratio 1.69 (1.08–2.64), p = 0.026; living in a rural area: odds ratio 1.54 (1.10–2.14), p = 0.014; regular physical labour: odds ratio 1.58 (1.13–2.19), p = 0.009; body mass index 35.0–40.0 kg/cm²: odds ratio 2.97 (1.95–4.52), p = 0.001 and over 40.0 kg/cm²: odds ratio 4.85 (1.07–22.07), p = 0.048); diabetes mellitus: odds ratio 2.33 (1.38–3.94), p = 0.002; haemoglobin A1c level ≥ 8.0 per cent: odds ratio 8.62 (1.83–40.57), p = 0.005; and chronic obstructive pulmonary disease: odds ratio 2.58 (1.13–5.87), p = 0.032.Conclusions. The most significant patient-related factors associated with the development of post-operative hernias are as follows: age over 61 years, living in a rural area, regular physical labour, a body mass index above 35.0 kg/cm² , diabetes mellitus, a glycated haemoglobin level of ≥8.0 per cent, and chronic pulmonary disease.