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The cost of preventable comorbidities on wound complications in open ventral hernia repair

Overview of attention for article published in Journal of Surgical Research, November 2016
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Title
The cost of preventable comorbidities on wound complications in open ventral hernia repair
Published in
Journal of Surgical Research, November 2016
DOI 10.1016/j.jss.2016.08.009
Pubmed ID
Authors

Tiffany C. Cox, Laurel J. Blair, Ciara R. Huntington, Paul D. Colavita, Tanushree Prasad, Amy E. Lincourt, B. Todd Heniford, Vedra A. Augenstein

Abstract

Patients with complex ventral hernias may benefit from preoperative optimization. This study evaluates the financial impact of preventable comorbidities (PCM) in elective open ventral hernia repair. In this single institution prospectively collected data from 2007-2011, hospital charges (included all hernia-related visits, interventions, or readmissions) and wound-related complications in patients with PCM-diabetes, tobacco use, and obesity-were compared to patients without such risks using standard statistical methods. Within the study period, there were 118 patients with no PCM; of those, 33 had complications, and 85 did not. In the 131 patients with two or more PCM, 81 had complications; 89 of 251 patients had complications in the group with only 1 PCM; groups with PCM were significantly more likely to have complications compared to the no PCM group (62% versus 35.4% versus 28%, P < 0.05). The majority of the patient population was female (57.2%) with a mean age of 57.8 y (range, 22-84 ys), and median defect size was 150 cm(2) (interquartile range, 50-283 cm(2)). Body mass index was higher in PCM group with complications than in PCM without complications (40 versus 36 kg/m(2), P < 0.05). For patients with complications, the average hospital charges were $80,660 in the PCM group compared to $55,444 in the no PCM group (P = 0.038). Hospital charges in those with PCM without complications compared to no PCM with complications were equivalent ($65,453 versus $55,444, P = 0.55). Even when no complications occurred, patients with PCM incurred higher charges than No PCM for inpatient ($61,269 versus $31,236, P < 0.02), outpatient ($4,185 versus $552, P < 0.04), and total hospital charges ($65,453 versus $31,788, P ≤ 0.001). Those patients without complications but with a single PCM incurred larger charges than those with no PCM during follow-up ($3578 versus $552, P = 0.04), but there was no difference in hospital or overall total charges (P > 0.05). Interestingly, patients without complications, both hospital ($38,333 versus $61,269, P = 0.02) and total charges ($41,911 versus $65,453, P = 0.01) were increased for patients with 2+ PCM compared to those with only a single PCM. If complications occurred, no difference between the single PCM group compared to the two or more PCM groups existed for hospital, follow-up, or overall charges (P > 0.05). Patients with PCM undergoing open ventral hernia repair are more likely to have complications than patients without comorbidities. Patients with PCM generate higher hospital charges than those without PCM even when no complications occur; furthermore, the more PCM, the patient has the more significant the impact. Interestingly, patients with multiple PCM and no complications had equivalent hospital costs compared to patients with no PCM and with complications. Aggressive risk reduction may translate into significant savings. Preoperative preparation of patients before elective surgery is indicated.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 66 100%

Demographic breakdown

Readers by professional status Count As %
Other 12 18%
Student > Postgraduate 10 15%
Researcher 10 15%
Student > Doctoral Student 7 11%
Student > Bachelor 7 11%
Other 14 21%
Unknown 6 9%
Readers by discipline Count As %
Medicine and Dentistry 43 65%
Agricultural and Biological Sciences 2 3%
Nursing and Health Professions 2 3%
Engineering 2 3%
Psychology 2 3%
Other 3 5%
Unknown 12 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 10 August 2016.
All research outputs
#9,749,043
of 12,196,802 outputs
Outputs from Journal of Surgical Research
#2,707
of 3,422 outputs
Outputs of similar age
#188,745
of 265,919 outputs
Outputs of similar age from Journal of Surgical Research
#111
of 154 outputs
Altmetric has tracked 12,196,802 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,422 research outputs from this source. They receive a mean Attention Score of 3.5. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
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 265,919 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 154 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.