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Genetic Susceptibility to Incisional Hernia Evaluation of Hernia Polygenic Risk Scores
Medrxiv : the Preprint Server for Health Sciences
|June 22, 2026
Summary
Genomic factors significantly increase incisional hernia (IH) risk, but polygenic risk scores (PRS) do not improve prediction models for patients undergoing abdominal surgery. Clinical factors remain crucial for IH risk assessment.
Area of Science:
- Genetics and Genomics
- Surgical Outcomes Research
- Biostatistics
Background:
- Incisional hernia (IH) is a common complication after abdominal surgery, leading to significant morbidity and healthcare costs.
- While clinical risk factors for IH are well-established, the role of genetic predisposition is less understood.
- Polygenic risk scores (PRS) offer a potential tool to quantify genetic susceptibility to complex diseases.
Purpose of the Study:
- To develop and evaluate PRS for predicting incisional hernia (IH) susceptibility.
- To assess the added value of PRS in improving IH risk prediction models beyond established clinical covariates.
- To investigate the association between genetic risk and IH development in a large biobank cohort.
Main Methods:
- Three PRS were created for abdominal, ventral, and latent hernia susceptibility.
- IH diagnosis or repair served as the primary outcome, identified via ICD and CPT codes.
- Phenome-wide association studies (PheWAS) and cross-validation models (5-fold, 10 iterations) were used to assess PRS performance against clinical factors.
Main Results:
- PRS were significantly associated with IH risk (OR 1.19 per SD increase, P < 0.001) and showed a 16% increased hazard in surgical patients (HR 1.16 per SD increase, P < 0.001).
- Despite significant associations, PRS did not substantially improve the predictive accuracy (Brier score, AUROC) of IH risk models at five years.
- Bayesian analysis indicated practical equivalence between models with and without PRS, suggesting no meaningful improvement in prediction.
Conclusions:
- Genomic factors, as captured by PRS, are independently associated with IH development.
- PRS do not significantly enhance the prediction of IH risk in patients undergoing abdominal surgery when clinical factors are considered.
- Clinical comorbidities and surgical techniques appear to be as important as genetic predisposition in IH development.
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