title: Correlation between early surgical complications and readmission rate after ventral hernia repair.
abstract: Postoperative surgical complications arising from ventral hernia repair have been assessed by a variety of outcome measures. The objective of this study was to correlate the Clavien Dindo Classification (CDC) graded complications with the 30-day readmission rate as early outcome measures in ventral hernia repair. Secondarily, we wanted to investigate whether the risk factors for Clavien Dindo class ≥1 and 30-day readmission were comparable.
  
  
  
  Single-centre retrospective study including all patients (≥18 years) who underwent ventral hernia repair between January 1, 2009 and September 1, 2014 at Zealand University Hospital. Data were obtained from hospital files and the Danish National Patient Registry. A 100% follow-up was obtained.
  
  
  
  In total, the study included 700 patients (261 patients with incisional hernia repair and 439 patients with umbilical or epigastric hernia repair). There was a significant association between a complication graded by the CDC ≥1 and 30-day readmission for both incisional and umbilical/epigastric hernia repair (p < 0.001). In incisional hernia, larger hernia size was an independent risk factor for CDC ≥1. No independent risk was found for 30-day readmission. Recurrent (vs. primary) hernia repair was an independent risk factors for both CDC ≥1 and 30-day readmission in umbilical/epigastric hernia repair. Furthermore, hernia size 2-7 cm (vs. >2 cm) was a risk factor for CDC ≥1 but not for 30-day readmission in umbilical/epigastric hernia repair.
  
  
  
  Reports on 30-day readmission can be used as a general outcome measure in ventral hernia repair, however CDC provides a more precise and detailed registration of postoperative complications.
authors.affiliation: Department of Surgery, Zealand Univeristy Hospital, Lykkebækvej 1, 4600, Køge, Denmark. dunja.kokotovic@hotmail.com.
authors.forename: D
authors.identifier: 0000-0003-1544-8927
authors.initials: D
authors.lastname: Kokotovic
authors.affiliation: Department of Surgery, Zealand Univeristy Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Sjølander
authors.affiliation: Department of Surgery, Zealand Univeristy Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Gögenur
authors.affiliation: Department of Surgery, Zealand Univeristy Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
authors.forename: F
authors.initials: F
authors.lastname: Helgstrand
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014472:Umbilicus / Q000601:surgery
keywords: 30-Day readmission; Clavien Dindo; Complications; Incisional hernia; Umbilical hernia; Validation