Rebeccah B Baucom1, Jenny Ousley2, Irene D Feurer3, Gloria B Beveridge2, Richard A Pierce2, Michael D Holzman2, Kenneth W Sharp2, Benjamin K Poulose2. 1. Department of Surgery, Vanderbilt University Medical Center, Nashville, 1161 Medical Center Drive, D-5203 Medical Center North, TN 37232, USA. Electronic address: rebeccah.baucom@vanderbilt.edu. 2. Department of Surgery, Vanderbilt University Medical Center, Nashville, 1161 Medical Center Drive, D-5203 Medical Center North, TN 37232, USA. 3. Department of Surgery, Vanderbilt University Medical Center, Nashville, 1161 Medical Center Drive, D-5203 Medical Center North, TN 37232, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Abstract
BACKGROUND: Assessing incisional hernia recurrence typically requires a clinical encounter. We sought to determine if patient-reported outcomes (PROs) could detect long-term recurrence. METHODS: Adult patients 1 to 5 years after incisional hernia repair were prospectively asked about recurrence, bulge, and pain at the original repair site. Using dynamic abdominal sonography for hernia to detect recurrence, performance of each PRO was determined. Multivariable regression was used to evaluate PRO association with recurrence. RESULTS: Fifty-two patients enrolled with follow-up time 46 ± 13 months. A patient-reported bulge was 85% sensitive, and 81% specific to detect recurrence. Patients reporting no bulge and no pain had 0% chance of recurrence. In multivariable analysis, patients reporting a bulge were 18 times more likely to have a recurrence than those without (95% confidence interval, 3.7 to 90.0; P < .001). CONCLUSIONS: This preliminary study demonstrates that PROs offer a promising means of detecting long-term recurrence after incisional hernia repair, which can help facilitate quality improvement and research efforts.
BACKGROUND: Assessing incisional hernia recurrence typically requires a clinical encounter. We sought to determine if patient-reported outcomes (PROs) could detect long-term recurrence. METHODS: Adult patients 1 to 5 years after incisional hernia repair were prospectively asked about recurrence, bulge, and pain at the original repair site. Using dynamic abdominal sonography for hernia to detect recurrence, performance of each PRO was determined. Multivariable regression was used to evaluate PRO association with recurrence. RESULTS: Fifty-two patients enrolled with follow-up time 46 ± 13 months. A patient-reported bulge was 85% sensitive, and 81% specific to detect recurrence. Patients reporting no bulge and no pain had 0% chance of recurrence. In multivariable analysis, patients reporting a bulge were 18 times more likely to have a recurrence than those without (95% confidence interval, 3.7 to 90.0; P < .001). CONCLUSIONS: This preliminary study demonstrates that PROs offer a promising means of detecting long-term recurrence after incisional hernia repair, which can help facilitate quality improvement and research efforts.
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