Document Detail


Predictors of in-hospital length of stay after laparoscopic ventral hernia repair: results of multivariate logistic regression analysis.
MedLine Citation:
PMID:  20419324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To identify variables that predict in-hospital length of stay (LOS) after laparoscopic ventral hernia repair (LVHR).
METHODS: Univariate analysis of patient and intraoperative variables was conducted on an operating room database of LVHRs performed from April 2001 to April 2009. Analysis was performed using either chi-square or linear trend analysis, as appropriate. A multivariate logistic regression model was created manually, to determine independent variables that predict LOS. p Value <0.05 was considered significant.
RESULTS: A total of 221 patients, with mean age of 56 years (range 25-88 years) underwent LVHR, for a total of 121 incisional and 100 primary ventral hernias. Of patients, 40% had incarcerated hernias and 25% had complex hernias (defined as multiple points of weakness on the anterior abdominal wall). The overall conversion rate to open operation was 6%. Mean LOS was 1.54 days (range 0-22 days). Eighty-six patients (39%) were discharged on the day of the procedure. Variables associated with significantly longer LOS on univariate analysis were incisional hernia (p = 0.000009), mesh size (p = 0.00007), complex hernia (p = 0.00009), incarcerated hernia (p = 0.0004), patient age (p = 0.0006), need for lysis of adhesions (p = 0.001), and female gender (p = 0.01). American Society of Anesthesiologists (ASA) grade >2, conversion to open procedure, and recurrent hernia were not associated with longer LOS. Four factors were independently associated with significant longer length of stay on multivariate logistic regression analysis (p < 0.05): mesh size (p = 0.00005), incarcerated hernia (p = 0.002), patient age (p = 0.018), and complex hernia (p = 0.035).
CONCLUSIONS: Mesh size, incarcerated hernia, patient age, and complex hernia predict longer length of stay after laparoscopic ventral hernia repair.
Authors:
Ashwin Kurian; Sidhbh Gallagher; Abhiman Cheeyandira; Robert Josloff
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Publication Detail:
Type:  Journal Article     Date:  2010-04-24
Journal Detail:
Title:  Surgical endoscopy     Volume:  24     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-18     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2789-92     Citation Subset:  IM    
Affiliation:
Department of Surgery, Abington Memorial Hospital, 604 Price Medical Building, 1200 Old York Road, Abington, PA 19001, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Hernia, Ventral / pathology,  surgery*
Humans
Laparoscopy* / methods
Length of Stay*
Male
Middle Aged
Postoperative Complications
Surgical Mesh

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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