title: Prevalence of systemic inflammation and micronutrient imbalance in patients with complex abdominal hernias.
abstract: OBJECTIVE
  To determine the prevalence of low-grade inflammation, micronutrient imbalances and associated clinical profiles in patients being evaluated for complex abdominal hernia repair.
  
  
  METHODS
  Review of 127 consecutive adult patients for evaluation of complex ventral hernias from January 2012 to March 2013. Records were analyzed to determine the prevalence and correlations of clinical risk factors, attributes of hernias identified by computerized tomography, and laboratory indices of metabolism, inflammation and micronutrient imbalances.
  
  
  RESULTS
  Strong correlations (p < 0.001) were established for body mass index (BMI) with volume of hernia content and C-reactive protein (CRP) level. CRP levels correlated strongly with red cell distribution width and inversely with zinc (p < 0.01). Evidence of micronutrient imbalance (abnormal zinc or red cell distribution width [RDW]) was observed in 48%.
  
  
  CONCLUSIONS
  In this comorbidity-rich population with known variability in surgical outcomes, the prevalence of chronic inflammation and micronutrient deficiency are high enough to warrant systemic preoperative evaluation given their possible effect on wound healing and convalescence. Simple repletion is unlikely to improve outcomes without attention to the biological stresses that are associated with micronutrient imbalance.
authors.affiliation: Department of Surgery,College of Medicine, The Pennsylvania State University, 500 University Drive, H047, P.O. Box 850, Hershey, PA, 17033-0850, USA.
authors.forename: Abby K
authors.initials: AK
authors.lastname: Geletzke
authors.forename: John M
authors.initials: JM
authors.lastname: Rinaldi
authors.forename: Brett E
authors.initials: BE
authors.lastname: Phillips
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Mobley
authors.forename: Jamie
authors.initials: J
authors.lastname: Miller
authors.forename: Thomas
authors.initials: T
authors.lastname: Dykes
authors.forename: Christopher
authors.initials: C
authors.lastname: Hollenbeak
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Kelleher
authors.forename: David I
authors.initials: DI
authors.lastname: Soybel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001806:Blood Urea Nitrogen; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D003404:Creatinine / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D006555:Hernia, Ventral / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D008297:Male; D018977:Micronutrients / Q000097:blood / Q000172:deficiency; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications; D015995:Prevalence; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D015032:Zinc / Q000097:blood*
chemical_list: D018977:Micronutrients; D012709:Serum Albumin; D002097:C-Reactive Protein; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D015032:Zinc