Abstract
Abstract Aim To evaluate the burden of incisional hernia (IH) to patients and healthcare services in England. Material & Methods We conducted a retrospective observational study in Hospital Episode Statistics including adult patients who underwent stoma, transplant, or aortic surgery (index) between 01/04/2017 and 31/03/2022. We followed patients for development of incisional (including parastomal) hernia necessitating repair within 2 years post-index operation, describing patients by surgery type, number of comorbidities (prior abdominal surgery, chronic lung disease, diabetes, immunosuppressed status, obesity, smoker), and financial year. We evaluated costs associated with inpatient, outpatient, and Accident & Emergency attendances within 2 years post-index operation using National Health Service reference costs. Results Of 430,339 patients (132,584 stoma, 3,247 transplant, 294,508 aortic surgery), 24,949 developed IH requiring repair (6.74% overall, 13.74% stoma, 5.51% transplant, 2.80% aortic surgery). Operative IH was observed in 11.46%, 5.54%, and 1.94%, for patients with 0–2 comorbidities following stoma, transplant, and aortic surgery, respectively; for patients with 5–6 comorbidities, 29.70%, 5.97%, and 6.91% underwent repair of IH. For all years, costs were higher for patients with IH versus those without IH. Costs varied by surgery type and number of comorbidities and were driven by non-elective admissions. The difference in mean total costs for IH versus non-IH following surgery performed in 2017 was £16,350 for stoma, £19,268 for transplant, and £54,518 for aortic surgery. Conclusions Rates of IH repair increase alongside the number of comorbidities. A large number of patients require IH repair within 2 years of surgery, increasing the cost of care.
Published Version
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