title: Management of umbilical hernias in patients with ascites: development of a nomogram to predict mortality.
abstract: BACKGROUND
  The objective of this study was to develop an easy-to-use nomogram to assist clinicians in predicting patient-specific mortality in this patient population.
  
  
  METHODS
  American College of Surgeons National Surgical Quality Improvement Program participant use files were used from 2005 to 2011. Multivariable logistic regression was used to model 30-day postoperative mortality in patients with ascites who underwent umbilical hernia repair.
  
  
  RESULTS
  A total of 688 patients with ascites undergoing umbilical hernia repair were included. There were 643 (94%) survivors and 45 (7%) mortalities. A total of 300 (44%) patients were classified as emergent cases. Using logistic regression to predict 30-day mortality, preoperative Model for End-Stage Liver Disease score, albumin, white blood cell count, and platelet count were found to be significant predictors (P < .05) of mortality and were included in our model.
  
  
  CONCLUSIONS
  We propose a nomogram to enable clinicians to better estimate mortality in patients with ascites undergoing umbilical hernia repair.
authors: Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors: Fady
authors: F
authors: Saleh
authors: Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors: Allan
authors: A
authors: Okrainec
authors: Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors: Sean P
authors: SP
authors: Cleary
authors: Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address: Timothy.Jackson@uhn.ca.
authors: Timothy D
authors: TD
authors: Jackson
mesh_terms: D001201:Ascites / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006554:Hernia, Umbilical / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D011237:Predictive Value of Tests; D011446:Prospective Studies; D058996:Quality Improvement; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Ascites; Mortality; Nomogram; Umbilical hernias