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01-02-2019 | Original Article

MELD-Na score associated with postoperative complications in hernia repair in non-cirrhotic patients

Authors: K. A. Schlosser, A. M. Kao, Y. Zhang, T. Prasad, K. R. Kasten, B. R. Davis, B. T. Heniford, P. D. Colavita

Published in: Hernia | Issue 1/2019

Abstract

Purpose

In patients with cirrhosis, the Model for End-Stage Liver Disease Sodium (MELD-Na) score is a validated predictor of outcomes after transplant and non-transplant surgical procedures. This study investigates the association of MELD-Na score with complications following elective ventral hernia repair in non-cirrhotic patients.

Methods

The ACS NSQIP database was queried (2005–2016) for all elective laparoscopic and open ventral hernia procedures in patients without ascites or esophageal varices. Postoperative outcomes were compared by MELD-Na score using Chi-square tests. Multivariate logistic regression was used to control for potentially confounding variables.

Results

A total of 48,955 elective hernia repairs were identified; 68.7% were open repairs. The overall complication rate (Clavien–Dindo ≥ 1) was 14.3%, with a wound complication rate of 5.5%, and major complication rate (Clavien–Dindo ≥ 3) of 4.3%. A preoperative MELD-Na score ≥ 10 was present in 29.4%. Incremental increases in MELD-Na score (10–14, 15–19, and ≥ 20) were associated with increased overall complications (OR 1.25, CI 1.31–1.37; OR 1.53, CI 1.30–1.80; OR 1.70, CI 1.24–2.31, respectively), major complications (OR 1.42, CI 1.20–1.69; OR 1.85, CI 1.43–2.39; OR 2.13, CI 1.35–3.38, respectively), 30-day mortality (OR 1.58, CI 1.05–2.37; OR 2.34, CI 1.39–3.96; OR 3.16, CI 1.37–7.28, respectively), and return to the operating room (OR 1.19, CI 1.01–1.41; OR 1.38, CI 1.05–1.81; OR 1.78, CI 1.10–2.90, respectively).

Conclusion

MELD-Na score is independently associated with postoperative complications in ventral hernia repair. As an objective and simple predictive model, it may be useful in preoperative risk calculations for complex patients.

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Title: MELD-Na score associated with postoperative complications in hernia repair in non-cirrhotic patients
Authors: K. A. Schlosser
A. M. Kao
Y. Zhang
T. Prasad
K. R. Kasten
B. R. Davis
B. T. Heniford
P. D. Colavita
Publication date: 01-02-2019
Publisher: Springer Paris
Published in: Hernia / Issue 1/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1849-2

At a glance: The STEP trials

Springer Medicine

MELD-Na score associated with postoperative complications in hernia repair in non-cirrhotic patients

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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