TY - JOUR
T1 - Causes of prolonged hospitalization after open incisional hernia repair
T2 - an observational single-center retrospective study of a prospective database
AU - Skovgaards, D M
AU - Diab, H M H
AU - Midtgaard, H G
AU - Jørgensen, L N
AU - Jensen, K K
N1 - © 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS part of Springer Nature.
PY - 2021/8
Y1 - 2021/8
N2 - PURPOSE: Enhanced recovery after surgery (ERAS) is a well-known approach to optimize the recovery after surgery. Little is known about specific causes of prolonged hospitalization despite enhanced recovery after open incisional hernia repair (OIHR). The purpose of this study was to identify the causes of continued hospitalization on each of the first 5 postoperative days (PODs) after OIHR.METHODS: This was a retrospective study of consecutive patients undergoing open AWR at a regional academic hernia center from 2008 to 2018. Patient charts were evaluated using predefined potential causes of continued hospitalization on each of the first five PODs.RESULTS: A total of 388 patients (mean age 60.9 years, 54.6% male, mean BMI 27.9 kg/m2) were included in the study. Mesh placement was either preperitoneal/intraperitoneal (20%) or retromuscular (80%) and 61% of the patients had an epidural catheter. The median length of stay (LOS) in the cohort was four [IQR 2-6] days. On PODs 4 and 5, causes of continued hospital stay were absent bowel function (2% on POD 4, 1% on POD 5), pain (7% on POD 3, 2% on POD 4), lack of mobilization (1% on POD 4, 1% on POD 5), and other causes (urinary retention, high drain output, and complications to the surgery).CONCLUSION: Causes for prolonged hospitalization after OIHR were possibly reducible. Future efforts to improve the ERAS regime and reduce LOS after OIHR should focus on pain treatment- and prevention, alternatives to epidural treatment, and well-defined, evidence-based discharge criteria.
AB - PURPOSE: Enhanced recovery after surgery (ERAS) is a well-known approach to optimize the recovery after surgery. Little is known about specific causes of prolonged hospitalization despite enhanced recovery after open incisional hernia repair (OIHR). The purpose of this study was to identify the causes of continued hospitalization on each of the first 5 postoperative days (PODs) after OIHR.METHODS: This was a retrospective study of consecutive patients undergoing open AWR at a regional academic hernia center from 2008 to 2018. Patient charts were evaluated using predefined potential causes of continued hospitalization on each of the first five PODs.RESULTS: A total of 388 patients (mean age 60.9 years, 54.6% male, mean BMI 27.9 kg/m2) were included in the study. Mesh placement was either preperitoneal/intraperitoneal (20%) or retromuscular (80%) and 61% of the patients had an epidural catheter. The median length of stay (LOS) in the cohort was four [IQR 2-6] days. On PODs 4 and 5, causes of continued hospital stay were absent bowel function (2% on POD 4, 1% on POD 5), pain (7% on POD 3, 2% on POD 4), lack of mobilization (1% on POD 4, 1% on POD 5), and other causes (urinary retention, high drain output, and complications to the surgery).CONCLUSION: Causes for prolonged hospitalization after OIHR were possibly reducible. Future efforts to improve the ERAS regime and reduce LOS after OIHR should focus on pain treatment- and prevention, alternatives to epidural treatment, and well-defined, evidence-based discharge criteria.
KW - Female
KW - Hernia, Ventral/surgery
KW - Herniorrhaphy/adverse effects
KW - Hospitalization
KW - Humans
KW - Incisional Hernia/surgery
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Surgical Mesh
UR - http://www.scopus.com/inward/record.url?scp=85098716014&partnerID=8YFLogxK
U2 - 10.1007/s10029-020-02353-w
DO - 10.1007/s10029-020-02353-w
M3 - Journal article
C2 - 33400029
SN - 1265-4906
VL - 25
SP - 1027
EP - 1034
JO - Hernia : the journal of hernias and abdominal wall surgery
JF - Hernia : the journal of hernias and abdominal wall surgery
IS - 4
ER -