Outcomes and quality of life in very elderly patients after ventral hernia repair.

Abstract

Elderly patients have higher risk of perioperative and postoperative complications. As the US life expectancy continues to increase, more patients aged ≥75 years are undergoing surgical procedures. We chose to evaluate postoperative and quality of life outcomes in elderly versus very elderly patients undergoing elective ventral hernia repair. A retrospective cohort study was performed with data from the Abdominal Core Health Collaborative from 2013 to 2020. Patients were aged ≥65 years who underwent elective ventral hernia repair with retromuscular mesh placement. Those missing 30-day follow-up or without baseline and 30-day Hernia-Related Quality-of-Life Survey scores were excluded. Propensity score matching was used, and statistical analyses were performed with Fisher exact test, Pearson test, and Wilcoxon test. Of 1,514 patients, 1,219 (81%) were 65-75 years old (elderly) and 295 (19%) were 76-90 years old (very elderly). There was no difference in 30-day mortality, readmissions, hernia recurrences, surgical site infections, surgical site occurrences, or other complications. The very elderly cohort had higher Hernia-Related Quality-of-Life Survey scores at baseline (P = .031), 30 days (P < .001), and 1 year (P = .007). Baseline and 1-year Patient-Reported Outcomes Measurement Information System pain 3A t scores were not different. The 30-day Patient-Reported Outcomes Measurement Information System pain 3A t scores were lower in the very elderly cohort (P = .016) and had greater decrease from baseline (P < .001). The risk profile and outcomes associated with ventral hernia repair were comparable between cohorts. Very elderly patients achieved equitable, if not greater, quality of life improvements.