Abdominal wall reconstruction risk stratification tools

A systematic review of the literature

Karla Bernardi, Gina L. Adrales, William W. Hope, Jerrod Keith, Heidi Kuhlens, Robert Martindale, Alyson A. Melin, Sean Orenstein, John Scott Roth, Shinil K. Shah, Shawn Tsuda, Mike K. Liang

Research output: Contribution to journalArticle

Abstract

Background: Ventral hernias are a common pathology encountered by surgeons. Multiple risk stratification tools have been developed in attempts to predict a patient's postoperative risk for complication. The aim of this systematic review was to identify published stratification tools, to assess their generalizability, and develop an ensemble risk score model. Methods: A systematic review of the literature was performed using PubMed and following the PRISMA guidelines. Two independent reviewers identified articles describing hernia stratification tools or validating an established tool. Inclusion criteria included articles that studied ventral hernia risk score models developed through expert consensus or from data of at least 500 subjects, performed a multivariable analysis of at least 500 patients, or assessed a previously reported model. Studies were grouped by primary outcome, and the odds ratios for correlated variables were compiled. Outcomes described in 4 or more articles were then stacked to generate a cumulative risk score model for patients undergoing abdominal wall repair. Results: A total of 20 articles were found to meet our inclusion criteria and used to develop our ensemble model. Surgical-site infection, surgical-site occurrence, and hernia recurrence were the 3 primary outcomes used to calculate our stacked cumulative risk stratification score. Conclusions: There are multiple risk score tools published; however, all have their strengths and limitations. For this reason, we created a composite score model with data from major articles to predict a patient's risk for postoperative complications. This model aims to ease the shared-decision making process for patients, surgeons, and institutions.

Original languageEnglish (US)
Pages (from-to)9S-20S
JournalPlastic and reconstructive surgery
Volume142
Issue number3S
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Fingerprint

Abdominal Wall
Ventral Hernia
Hernia
Surgical Wound Infection
PubMed
Consensus
Decision Making
Odds Ratio
Guidelines
Pathology
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Abdominal wall reconstruction risk stratification tools : A systematic review of the literature. / Bernardi, Karla; Adrales, Gina L.; Hope, William W.; Keith, Jerrod; Kuhlens, Heidi; Martindale, Robert; Melin, Alyson A.; Orenstein, Sean; Roth, John Scott; Shah, Shinil K.; Tsuda, Shawn; Liang, Mike K.

In: Plastic and reconstructive surgery, Vol. 142, No. 3S, 01.09.2018, p. 9S-20S.

Research output: Contribution to journalArticle

Bernardi, K, Adrales, GL, Hope, WW, Keith, J, Kuhlens, H, Martindale, R, Melin, AA, Orenstein, S, Roth, JS, Shah, SK, Tsuda, S & Liang, MK 2018, 'Abdominal wall reconstruction risk stratification tools: A systematic review of the literature', Plastic and reconstructive surgery, vol. 142, no. 3S, pp. 9S-20S. https://doi.org/10.1097/PRS.0000000000004833
Bernardi, Karla ; Adrales, Gina L. ; Hope, William W. ; Keith, Jerrod ; Kuhlens, Heidi ; Martindale, Robert ; Melin, Alyson A. ; Orenstein, Sean ; Roth, John Scott ; Shah, Shinil K. ; Tsuda, Shawn ; Liang, Mike K. / Abdominal wall reconstruction risk stratification tools : A systematic review of the literature. In: Plastic and reconstructive surgery. 2018 ; Vol. 142, No. 3S. pp. 9S-20S.
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