| Title |
What is the BMI threshold for open ventral hernia repair?
|
|---|---|
| Published in |
Surgical Endoscopy, July 2016
|
| DOI | 10.1007/s00464-016-5113-5 |
| Pubmed ID | |
| Authors |
Luise I. M. Pernar, Claire H. Pernar, Bryan V. Dieffenbach, David C. Brooks, Douglas S. Smink, Ali Tavakkoli |
| Abstract |
Overweight and obese patients are often asked to lose weight prior to ventral hernia repair (VHR). Improved outcomes are the reasons behind this strategy. Data regarding weight loss targets are scant, and it is not known at what body mass index (BMI) threshold postoperative complications increase. This study aimed to determine the threshold to allow proper patient counseling. All patients who underwent open VHR at our institution between 2002 and 2015 captured in the NSQIP database were included. The primary outcome was defined as any (≥1) of 18 captured postoperative complications. Patients were divided into five groups based on BMI: group 1 (<25 kg/m(2)); 2 (25-29.99 kg/m(2)); 3 (30-34.99 kg/m(2)); 4 (35-39.99 kg/m(2)); and 5 (≥40 kg/m(2)). Multivariable, adjusted logistic regression was performed to evaluate the association between BMI categories and postoperative complications. Sixty seven of 922 patients (7.3 %) had at least one postoperative complication following VHR. The adjusted odds of complications in group 5 was 2.89 times greater compared to group 1 (OR 2.89; 95 % CI = 1.22-6.84), while there was no significant differences in odds of postoperative complications for groups 2, 3, or 4 compared to group 1. BMI category was also significantly associated with undergoing recurrent VHR, with 28.7 % of patients in group 5 having a recurrent repair compared to 14 % in patients in group 1 (p = 0.03). After VHR, complications are most likely to occur in patients with BMI ≥ 40 kg/m(2). This subset of patients also had a significantly higher risk of undergoing surgery for a recurrent hernia, suggesting that this group of patients is likely to experience adverse outcomes after VHR and should be counseled to consider bariatric surgery prior to attempts at VHR. VHR at lower BMIs appears appropriate, and delaying therapy to achieve preoperative weight loss will likely offer no advantage. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 43% |
| Unknown | 4 | 57% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 3 | 43% |
| Practitioners (doctors, other healthcare professionals) | 3 | 43% |
| Members of the public | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 88 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 1% |
| Unknown | 87 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 11 | 13% |
| Student > Doctoral Student | 11 | 13% |
| Student > Master | 9 | 10% |
| Other | 8 | 9% |
| Student > Bachelor | 7 | 8% |
| Other | 20 | 23% |
| Unknown | 22 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 46 | 52% |
| Nursing and Health Professions | 4 | 5% |
| Psychology | 2 | 2% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Social Sciences | 1 | 1% |
| Other | 3 | 3% |
| Unknown | 30 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 July 2016.
All research outputs
#7,036,681
of 23,666,309 outputs
Outputs from Surgical Endoscopy
#1,438
of 6,323 outputs
Outputs of similar age
#116,481
of 366,578 outputs
Outputs of similar age from Surgical Endoscopy
#41
of 193 outputs
Altmetric has tracked 23,666,309 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 6,323 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 366,578 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 193 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.