Association of body mass index with 30-day outcomes following groin hernia repair.

Abstract

Although groin hernia repairs are relativelysafe, efforts to identify factors associated with greater morbidity and resource utilization following these operationsare warranted. An emphasis on obesity has limited studies from a comprehensive evaluation of the associationbetween body mass index (BMI) and outcomes following groin hernia repair. Thus, we aimed to ascertain theassociation between BMI class with 30-day outcomes following these operations. The 2014-2020 National Surgical Quality Improvement Program database was queried to identify adults undergoingnon-recurrent groin hernia repair. Patient BMI was used to stratify patients into six groups: underweight, normal,overweight, and obesity classes I-III. Association of BMI with major adverse events (MAE), wound complication,and prolonged length of stay (pLOS) as well as 30-day readmission and reoperation were evaluated usingmultivariable regressions. Of the 163,373 adults who underwent groin hernia repair, themajority of patients were considered overweight (44.4%). Underweight patients more commonly underwentemergent operations and femoral hernia repair compared to others. After adjustment of intergoup differences,obesity class III was associated with greater odds of an MAE (AOR 1.50), wound complication (AOR 4.30), pLOS(AOR 1.40), and 30-day readmission (AOR 1.50) and reoperation (AOR 1.75, all p < 0.05). Underweight BMIportended greater odds of pLOS and unplanned readmission. Consideration of BMI inpatients requiring groin hernia repair could help inform perioperative expectations. Preoperative optimization anddeployment of a minimally invasive approach when feasible may further reduce morbidity in patients at theextremes of the BMI spectrum.