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Age-Related Risk Factors in Ventral Hernia Repairs: A Review and Call to Action
Julia Hamilton1, Bradley Kushner1, Sara Holden1
1Department of Surgery, Washington University School of Medicine. St. Louis, Missouri.
The Journal of Surgical Research
|May 20, 2021
Summary
Age-related factors, not just age, significantly impact ventral hernia repair outcomes in older adults. Addressing these risks preoperatively can improve surgical results and patient well-being.
Area of Science:
- Geriatric Surgery
- Surgical Outcomes Research
Background:
- Ventral hernia repairs (VHR) are increasingly common in aging populations.
- Older adults face higher surgical risks due to age-related factors, yet their impact on VHR is understudied.
Purpose of the Study:
- To systematically review the literature on age-related risk factors affecting VHR outcomes.
- To identify key factors that influence mortality and complications in older adults undergoing VHR.
Main Methods:
- Systematic literature review across major databases (Cochrane, Embase, PubMed, Google Scholar) updated through June 2020.
- Keywords included multimorbidity, polypharmacy, frailty, sarcopenia, and cognitive impairment.
- Primary outcomes assessed were mortality and overall complications post-VHR.
Main Results:
- Age-related risk factors significantly increase the likelihood of adverse outcomes in VHR.
- Multimorbidity, polypharmacy, functional dependence, frailty, cognitive impairment, sarcopenia, and malnutrition are key predictors of VHR complications.
- These factors are more clinically relevant than chronological age alone in determining VHR outcomes.
Conclusions:
- Preoperative assessment and management of age-related risk factors are crucial for improving VHR outcomes in older adults.
- Individualized prehabilitation programs can enhance patient-centered outcomes.
- Addressing frailty, sarcopenia, and cognitive status pre-VHR is essential for optimizing surgical success.
