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Purpose <p>Decision regret following hernia repair is common, particularly for patients who experience complications. Frailty is a risk factor for complications, but whether frailty is independently associated with regret remains unknown.</p> Methods <p>We retrospectively reviewed the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry, a representative sample of adult patients from &gt; 70 hospitals across Michigan. We included patients who underwent elective ventral and incisional hernia repair (VIHR) or groin hernia repair (GHR) from 2020 to 2021 and completed a survey measuring regret. Frailty was quantified using validated 5-factor modified frailty index (mFI5): no (mFI5 = 0), moderate (mFI5 = 1), or severe frailty (mFI5 ≥ 2). Primary outcome was regret at 90-days. Multivariable regression models evaluated the association of frailty with regret.</p> Results <p>795 patients underwent VIHR: 294 (37.0%) were moderately frail, and 127 (16.0%) were severely frail. Severely frail patients were older, more often male, more comorbid, had higher BMI, and had larger hernias (all <i>p</i> &lt; 0.05). Regret was demonstrated in 88 patients (11.1%). 2502 patients underwent GHR: 966 (38.6%) moderately frail, and 213 (8.5%) severely frail. Severely frail patients were older, had higher BMI, and more comorbidities (all <i>p</i> &lt; 0.001). 271 persons (10.8%) expressed regret. For both VIHR and GHR, frailty was not associated with regret (<i>p</i> &gt; 0.05). There were no differences in complications by frailty status (<i>p</i> = 0.10 and <i>p</i> = 0.22).</p> Conclusion <p>Despite their higher risk, persons with frailty are not more likely to express regret following hernia repair. Decision regret is important for evaluating quality-of-life operations, but frailty status should not be used alone to predict risk of decision regret.</p>

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Impact of preoperative frailty status on decision regret following elective hernia repair

  • 期刊论文

  • 发表日期：

    2025年1月23日

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  • Leah J Schoel,
  • Joshua Sinamo,
  • Brian T Fry,
  • Alexander Hallway,
  • Michael Rubyan,
  • Ryan Howard,
  • Jenny M Shao,
  • Sean M O’Neill,
  • Dana A Telem,
  • Annie P Ehlers

摘要

Purpose

Decision regret following hernia repair is common, particularly for patients who experience complications. Frailty is a risk factor for complications, but whether frailty is independently associated with regret remains unknown.

Methods

We retrospectively reviewed the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry, a representative sample of adult patients from > 70 hospitals across Michigan. We included patients who underwent elective ventral and incisional hernia repair (VIHR) or groin hernia repair (GHR) from 2020 to 2021 and completed a survey measuring regret. Frailty was quantified using validated 5-factor modified frailty index (mFI5): no (mFI5 = 0), moderate (mFI5 = 1), or severe frailty (mFI5 ≥ 2). Primary outcome was regret at 90-days. Multivariable regression models evaluated the association of frailty with regret.

Results

795 patients underwent VIHR: 294 (37.0%) were moderately frail, and 127 (16.0%) were severely frail. Severely frail patients were older, more often male, more comorbid, had higher BMI, and had larger hernias (all p < 0.05). Regret was demonstrated in 88 patients (11.1%). 2502 patients underwent GHR: 966 (38.6%) moderately frail, and 213 (8.5%) severely frail. Severely frail patients were older, had higher BMI, and more comorbidities (all p < 0.001). 271 persons (10.8%) expressed regret. For both VIHR and GHR, frailty was not associated with regret (p > 0.05). There were no differences in complications by frailty status (p = 0.10 and p = 0.22).

Conclusion

Despite their higher risk, persons with frailty are not more likely to express regret following hernia repair. Decision regret is important for evaluating quality-of-life operations, but frailty status should not be used alone to predict risk of decision regret.