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Introduction <p>Lower socioeconomic status is associated with worse patient quality of life scores and a higher risk of morbidity and mortality. One of the most important outcome measures in elective ventral hernia repair is quality of life. The relationship between socioeconomic status and improvement in quality of life has not been explored in ventral hernia patients. Using the Distressed Communities Index (DCI), we explored the relationship between socioeconomic distress and post-operative quality of life.</p> Methods <p>Retrospective analysis performed using data from Abdominal Core Health Collaborative. Included were adults (≥ 18&#xa0;years old) who underwent elective ventral hernia repair from 2013 to 2023. Quintiles were created based on DCI score. Kruskal–Wallis and Pearson tests were used as appropriate.&#xa0;Logistic regression was performed for 30-day readmission, surgical site infection (SSI), surgical site occurrence (SSO), and SSI/O requiring procedural intervention across quintiles. 30-day and one-year general linear modeling was used for HerQLes scores across quintiles.</p> Results <p>Of 38,211 patients, 5319 (14%) lived in distressed, 5707 (15%) in at-risk, 6820 (18%) in mid-tier, 8526 (22%) in comfortable, and 11,839 (31%) in prosperous communities. More distressed communities were younger with higher ASA class and BMI (p &lt; 0.001). They presented with larger hernia sizes and underwent higher rates of open repair (p &lt; 0.001). After logistic regression, there was no difference in 30-day readmission, SSI, or HerQLes score changes. There was no difference in HerQLes score changes between quintiles at 30-day or one-year based on linear regression modeling.</p> Conclusion <p>Patients from more distressed communities were more likely to present in worse clinical status with a more complicated disease process and subsequent higher 30-day complication rates and recurrences. Despite higher complication rates, patients from more distressed communities had significantly greater improvements in HerQLes scores from baseline at 30 days and one year post-operatively compared to their more prosperous counterparts.</p>

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The effect of socioeconomic status on quality of life following ventral hernia repair

  • 期刊论文

  • 发表日期：

    2025年12月15日

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  • Courtney M. Collins,
  • William T. Head,
  • Savannah Renshaw,
  • Li-Ching Huang,
  • Sharon Phillips,
  • Courtney E. Collins

摘要

Introduction

Lower socioeconomic status is associated with worse patient quality of life scores and a higher risk of morbidity and mortality. One of the most important outcome measures in elective ventral hernia repair is quality of life. The relationship between socioeconomic status and improvement in quality of life has not been explored in ventral hernia patients. Using the Distressed Communities Index (DCI), we explored the relationship between socioeconomic distress and post-operative quality of life.

Methods

Retrospective analysis performed using data from Abdominal Core Health Collaborative. Included were adults (≥ 18 years old) who underwent elective ventral hernia repair from 2013 to 2023. Quintiles were created based on DCI score. Kruskal–Wallis and Pearson tests were used as appropriate. Logistic regression was performed for 30-day readmission, surgical site infection (SSI), surgical site occurrence (SSO), and SSI/O requiring procedural intervention across quintiles. 30-day and one-year general linear modeling was used for HerQLes scores across quintiles.

Results

Of 38,211 patients, 5319 (14%) lived in distressed, 5707 (15%) in at-risk, 6820 (18%) in mid-tier, 8526 (22%) in comfortable, and 11,839 (31%) in prosperous communities. More distressed communities were younger with higher ASA class and BMI (p < 0.001). They presented with larger hernia sizes and underwent higher rates of open repair (p < 0.001). After logistic regression, there was no difference in 30-day readmission, SSI, or HerQLes score changes. There was no difference in HerQLes score changes between quintiles at 30-day or one-year based on linear regression modeling.

Conclusion

Patients from more distressed communities were more likely to present in worse clinical status with a more complicated disease process and subsequent higher 30-day complication rates and recurrences. Despite higher complication rates, patients from more distressed communities had significantly greater improvements in HerQLes scores from baseline at 30 days and one year post-operatively compared to their more prosperous counterparts.