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. Author manuscript; available in PMC: 2022 Oct 1.
Published in final edited form as: J Surg Res. 2021 May 17;266:180–191. doi: 10.1016/j.jss.2021.04.004

Table 1.

Primary Sources Investigating the Impact of Age-Related Risk Factors on VHR Outcomes

Age-Related Risk Factor Source Sample Size Procedure(s)a Database Operation-alization of Age-Related Risk Factor Results
Outcome OR 95% CI
Multimorbidity Wolf et al. 2016 92,295 Inpatient, open & laparoscopic VHRs 2003–2011 U.S. Nationwide Inpatient Sample CCI ≥ 3 Need for emergency VHR 1.68* 1.56–1.80
In-hospital mortality 4.02* 3.03–5.33
Basta et al. 2016 55,760 Inpatient, open VHR 2005–2012 ACS-NSQIP ASA ≥ 3 30-day mortality 2.63* 1.94–3.57
Ayyala et al. 2020 4,549 Complex abdominal wall reconstruction 2005–2016 ACS-NSQIP ASA ≥ 3 Non-home discharge 1.71* 1.083–2.708
2+ comorbiditiesb ≥ 3.88* -
Functional Status Albright et al. 2012 76,397 All types of VHRs 2005–2010 ACS-NSQIP Ability to perform ADLs PDP: 30-day mortality 4.48* 3.20–6.28
TDP: 30-day mortality 11.55* 7.58–17.59
PDP: 30-day operation 2.11* 1.70–2.62
TDP: 30-day operation 3.01* 2.13–4.25
PDP & TDP: Complicationsc ≥ 1.52* -
Balla et al. 2019 97,905 Open & laparoscopic VHRs 2011–2016 ACS-NSQIP Ability to perform ADLs Overall complications 2.97* 2.88–3.05
Major complications 3.51* 3.43–3.57
Non-home discharge 13.43* 12.42–14.71
Mortality NR NR
Basta et al. 2016 55,760 Inpatient, open VHR 2005–2012 ACS-NSQIP Ability to perform ADLs 30-day mortality 2.64* 1.92–3.62
Ayyala et al. 2020 4,549 Complex abdominal wall reconstruction 2005–2016 ACS-NSQIP Ability to perform ADLs Non-home discharge 4.448* 1.742–11.360
Frailty Joseph et al. 2020 70,339 Complex abdominal wall reconstruction 2005–2013 ACS-NSQIP 11-variable mFI Overall complications 7.77* 5.97–10.13
Major complications 35.71* 23.32–54.69
Surgical site complications 3.85* 2.77–5.36
30-day mortality 62.05* 28.78–133.80
Readmissions 1.4 0.44–4.49
Balla et al. 2019 97,905 Open & laparoscopic VHRs 2011–2016 ACS-NSQIP 5-variable mFId Overall complicationsd ≥ 1.15* -
Major complicationsd ≥ 1.21* -
Non-home discharged ≥ 1.22* -
Mortalityd NR NR
Sarcopenia Barnes et al. 2018 58 VHR with component separation 2009–2013 institutional database HUAC < 19.6 Overall complications 5.31* 1.121–25.174
Readmissionse MD: 0.07 p = .91
Repeat surgical interventionse MD: 0.20 p = .48
Rinaldi et al. 2016 148 Elective complex VHR 2011–2013 one surgeon’s database Males: SMI ≤ 52.4; Females: SMI ≤ 38.5 Duration of ileuse MD = 1.25* p = .0156
Length of hospital staye MD = 2.18* p = .0218
Recurrencee MD = 9 p = 1.0000
SSOe MD = 20 p = .1137
Siegal et al. 2018 135 All types of VHRs 2014–2015 two surgeons’ database Males: SMI ≤ 52.4; Females: SMI ≤ 38.5 Overall complicationse MD = 30 p = .701
Recurrencee MD = 17 p = .895
SSOe MD = 31 p = .113
SSIe MD = 22 p = .140
Length of hospital staye MD = 0 p = .988
SMI decrease of 10 Overall complications 1.44* 1.00–2.07
Schlosser et al. 2019 1,178 Open VHR 2007–2018 institutional database Males: SMI ≤ 54.5; Females: SMI ≤ 38.5 Major complications NR NR
SSO NR NR
Recurrence NR NR
Readmissions NR NR
Reoperation NR NR
Nutritional Statusf Basta et al. 2016 55,760 Inpatient, open VHR 2005–2012 ACS-NSQIP 10% weight loss over past 6 months 30-day mortality 1.37* 1.03–1.81
BMI < 19.0 30-day mortality 3.23* 1.75–5.95
Owei et al. 2017 102,191 Open VHR 2005–2015 ACS-NSQIP BMI < 18.5 Overall complications 1.26 0.93–1.70
Polypharmacy No VHR studies to date.
Cognitive Status No VHR studies to date.

Abbreviations: Asterisk signifies significant results (p < .05); Dash (−) signifies that data is not applicable; NR: Not reported; MD: Mean difference; OR: Odds Ratio; 95% CI: 95% Confidence Interval; CCI: Charlson Comorbidity Index; ASA: American Society of Anesthesiologists Physical Status Classification; SSI: surgical site infections; SSO: surgical site occurrence; PDP: partially dependent patients; TDP: totally dependent patients; ADLs: activities of daily living; mFI: modified Frailty Index; HUAC: Hounsfield unit average calculation (HU); SMI: skeletal muscle index (cm2/m2); BMI: body mass index (kg/m2);

Notes:

a)

Unless otherwise noted, studies did not mention filtering VHRs by elective/emergent procedures or by inpatient/outpatient settings.

b)

Patients with 0 comorbidity are separately compared to those with 2, 3, 4, 5, 6, and 7+ comorbidities. All comparisons are significant.

c)

Each complication is considered separately. Partial and total dependence are significantly associated with superficial SSI, wound dehiscence, pneumonia, ventilation > 48 h, UTI, DVT, and sepsis. Acute MI and deep SSI/pulmonary embolism are significantly associated with partial and total dependence, respectively. All other comparisons are nonsignificant.

d)

Authors report statistics for each variable, rather than for total mFI.

e)

MD and p-value are reported, rather than OR and 95% CI, respectively. Student’s t-test, rank-sum test, or chi-square test was used to compare patients with and without sarcopenia.

f)

This table does not include findings on overnutrition, due to the large number of relevant studies.