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

Abstract

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>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.