Evidence map›Paper›PMID 26465784›Full record

ArticleAnnals of surgery2016

A Risk Model and Cost Analysis of Incisional Hernia After Elective, Abdominal Surgery Based Upon 12,373 Cases: The Case for Targeted Prophylactic Intervention.

John P Fischer, Marten N Basta, Michael N Mirzabeigi, Andrew R Bauder, Justin P Fox, Jeffrey A Drebin, Joseph M Serletti, Stephen J Kovach

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. The impact of smoking on ventral and inguinal hernia repair: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Pooled it
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  10. Trial
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  13. Review
  14. Incisional hernia prediction using machine learning models.BMC medical informatics and decision making · 2026
    Observational
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  18. External validation of the IHXGboost-P model to predict incisional hernia after midline laparotomy.Hernia : the journal of hernias and abdominal wall surgery · 2026
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  20. Article

6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

John P Fischer*Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA †Division of Gastrointestinal Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA.
Marten N Basta
Michael N Mirzabeigi
Andrew R Bauder
Justin P Fox
Jeffrey A Drebin
Joseph M Serletti
Stephen J Kovach

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIncisional hernia (IH) remains a common, highly morbid, and costly complication. Modest progress has been realized in surgical technique and mesh technology; however, few advances have been achieved toward understanding risk and prevention. In light of the increasing emphasis on prevention in today's health care environment and the billions in costs for surgically treated IH, greater focus on predictive risk models is needed.

methodsAll patients undergoing gastrointestinal or gynecologic procedures from January 1, 2005 to June 1, 2013, within the University of Pennsylvania Health System were identified. Comorbidities and operative characteristics were assessed. The primary outcome was surgically treated IH after index procedures. Patients with prior hernia, less than 1-year follow-up, or emergency surgical procedures were excluded. Cox hazard regression modeling with bootstrapped validation, risk factor stratification, and assessment of model performance were conducted.

resultsA total of 12,373 patients with a 3.5% incidence of surgically treated IH (follow-up 32.2 ± 26.6 months) were identified. The cost of surgical treatment of IH and management of associated complications exceeded $17.5 million. Notable independent risk factors for IH were ostomy reversal (HR = 2.76), recent chemotherapy (HR = 2.04), bariatric surgery (HR = 1.78), smoking history (HR = 1.74), liver disease (HR = 1.60), and obesity (HR = 1.96). High-risk patients (20.6%) developed IH compared with 0.5% of low-risk patients (C-statistic = 0.78).

conclusionsThis study demonstrates an internally validated preoperative risk model of surgically treated IH after 12,000 elective, intra-abdominal procedures to provide more individualized risk counseling and to better inform evidence-based algorithms for the role of prophylactic mesh.

Indexed as

Elective Surgical ProceduresAbdominal WallAdultAgedAged, 80 and overAlgorithmsComorbidityCosts and Cost AnalysisFemaleHumansIncidenceIncisional HerniaMaleMiddle AgedPostoperative ComplicationsRetrospective Studies

Identifiers

PMID26465784
PMCPMC4825112

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.