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Leveraging a statewide quality collaborative to understand population-level hernia care
Ryan Howard1, Anne Ehlers1, Lia Delaney2
1Department of Surgery, University of Michigan, Ann Arbor, MI, USA; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
American Journal of Surgery
|June 6, 2021
Summary
Ventral hernia repair (VHR) shows significant practice variation. Mesh use and outcomes in VHR depend on hernia size, highlighting the need for data-driven clinical practice improvements.
Area of Science:
- Surgical outcomes research
- Hernia surgery epidemiology
- Health services research
Background:
- Ventral hernia repair (VHR) is a common procedure with substantial variability in techniques and patient outcomes.
- Understanding population-level practice patterns is crucial for improving VHR quality.
Purpose of the Study:
- To describe practice patterns and outcomes of VHR using a statewide registry.
- To analyze hernia-specific variables and their association with operative choices and complications.
Main Methods:
- Retrospective analysis of adult patients undergoing VHR in 2020.
- Data collected from a new statewide hernia registry, including 919 patients from 57 hospitals and 279 surgeons.
Main Results:
- Hernia width varied, with 46% of hernias measuring 2-5 cm.
- Mesh use was prevalent (79%) and increased with hernia size, ranging from 53% for small hernias to 95% for large ones.
- Complication incidence was significantly associated with hernia width, with synthetic non-absorbable mesh being most common.
Conclusions:
- A statewide hernia registry successfully captured detailed operative data for a large VHR cohort.
- Significant variation in mesh utilization and outcomes based on hernia size was observed.
- These population-level data offer insights for enhancing clinical practice in VHR.
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