title: A nationwide study on readmission, morbidity, and mortality after umbilical and epigastric hernia repair.
abstract: BACKGROUND
  Repair for umbilical and epigastric hernia is a minor and common surgical procedure. Early outcomes are not well documented.
  
  
  METHODS
  All patients ≥18 years operated on for umbilical or epigastric hernia in Denmark during a 2-year period (2005-2006) were analysed according to hospital stay, risk of readmission, complications, and mortality <30 days after operation. Patients with acute operations and patients having an umbilical and epigastric hernia repair secondary to other surgical procedures were excluded. Results were based on data from the National Patient Registry.
  
  
  RESULTS
  A total 3,431 operations (open repairs 3,165; laparoscopic repairs 266) in 3,383 patients were performed. The median hospital stay was 0 day (range 0-61 days) (open 0 day; laparoscopic 1 day); 75% stayed in hospital for 0 days, 20% for 1 day and 5% > 1 day. Readmissions occurred in 5.3% of cases (open 4.9%; laparoscopic 10.5%). In the majority of patients readmissions were due to wound-related problems (haematoma, bleeding and/or infection) (46%), seroma (19%), or pain (7%). At 30 days, complications and mortality occurred in 4.1% (open 3.7%; laparoscopic 8.2%) and 0.1% (open 0.1%; laparoscopic 0.4%), respectively.
  
  
  CONCLUSIONS
  This first prospective nationwide study on elective umbilical and epigastric hernia repair found low morbidity and mortality but a high readmission rate mostly because of wound problems, seroma formation, or pain. Future research should focus on early outcomes in terms of wound problems, seroma formation, and pain after umbilical and epigastric hernia repair.
authors.affiliation: Danish Hernia Database, Køge Hospital, University of Copenhagen, Copenhagen, Denmark. thuebisgaard@tdcadsl.dk
authors.forename: T
authors.initials: T
authors.lastname: Bisgaard
authors.forename: H
authors.initials: H
authors.lastname: Kehlet
authors.forename: M
authors.initials: M
authors.lastname: Bay-Nielsen
authors.forename: M G
authors.initials: MG
authors.lastname: Iversen
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
authors.forename: L N
authors.initials: LN
authors.lastname: Jørgensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D005260:Female; D006406:Hematoma / Q000209:etiology; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D049291:Seroma / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D055815:Young Adult