An Observational Cohort Study on Non-Recurrence Procedural Intervention and Reoperation for Recurrence After Ventral Hernia Repair.

Abstract

To establish the use of Non-Recurrence Procedural Intervention (NRPI) and Reoperation for Recurrence (ROR) as long-term outcome measures after ventral hernia repair (VHR). NRPI is a novel, claims-based measure sensitive to procedures performed to manage complications after VHR. Obtaining long-term follow-up after VHR is difficult. Clinical registry linkages with administrative claims data offer a novel solution to assess long-term complications and recurrence. This study provides validation of coding algorithms for these outcomes to ensure reproducibility and scalability. This was an observational cohort study of patients undergoing VHR from 2011-2019 at a single tertiary care center. Claims-based coding algorithms for NRPI and ROR were compared to abstracted electronic health record (EHR) information. The main outcome was cumulative incidence of long-term NRPI and ROR. P<0.007 was significant using Bonferroni adjustment. 1,229 patients were identified (50% female, 80% white race). Forty-three percent underwent minimally invasive VHR. Median hernia width was 3 cm (IQR 2 cm-6 cm). Median follow-up was 4.5 years for adminstrative and EHR data. The cumulative incidence of NRPI remained similar for claims 7.17% (95%CI 5.73-8.62%) and EHR 5.54% (95%CI 4.26-6.82%), P=0.0184. Similar results were found for ROR: claims 6.84% (95%CI 5.43-8.25%) and EHR 7.00% (95%CI 5.58-8.43%), P=0.6547. NRPI and ROR cumulative incidence rates are similar using the claims-based coding algorithm and EHR data. The algorithm can be used to enhance long-term follow-up through clinical registry linkages with administrative claims data. This will enable robust long-term assessment for research, quality improvement, and post-market device surveillance.