Evidence map›Paper›PMID 31781965›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2019

The impact of preoperative anxiety, depression, and chronic pain on outcomes in abdominal wall reconstruction.

K A Schlosser, S R Maloney, T Prasad, K Kercher, B T Heniford, V A Augenstein

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

6 authors.

K A SchlosserDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA.
S R MaloneyDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA.
T PrasadDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA.
K KercherDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA.
B T HenifordDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA.
V A AugensteinDepartment of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA. Vedra.Augenstein@atriumhealth.org.ORCID http://orcid.org/0000-0002-4507-9707

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAn association of anxiety with surgical outcomes has been suggested, including with open ventral hernia repair (OVHR). This study examines the interaction of multiple comorbidities, including anxiety, depression, chronic pain, and hernia characteristics with outcomes after OVHR.

methodsPatients with anxiety were identified in an existing, prospectively collected, data set of OVHR with preoperative work-up including CT scans (2007-2018). A patient with a diagnosis or prescription for anxiolytics, anti-depressants, or narcotics was considered to have anxiety, depression, or chronic pain, respectively. Hernia characteristics were analyzed using 3D volumetric software. Univariate and multivariate analyses were performed to assess for the impact of anxiety on surgical outcomes.

resultsA total of 1178 OVHRs were identified. The diagnosis of anxiety (23.9%) was associated with female gender (29.1% females vs. 16.9% males, p = 0.002), depression (56.7 vs. 18.8%, p < 0.0001), preoperative chronic pain (43.6 vs. 26.9%, p < 0.0001), COPD, arrhythmia, history of MRSA, and sleep apnea (p ≤ 0.05 all values). Patients with anxiety had larger hernia volume and defect size, and were more likely to undergo component separation, with higher rates of wound complication and intervention for pain (p ≤ 0.05 all values). After multivariate analysis controlling for multiple potentially confounding factors, the comorbidities of anxiety, depression, and preoperative chronic pain were not found to be significantly associated with adverse outcomes.

conclusionsThe diagnosis of anxiety is associated with preoperative comorbidity, surgical complexity, and adverse outcomes after OVHR. However, when comorbidities are controlled for, the diagnosis of anxiety, depression or preoperative pain does not independently predict adverse outcomes. In this context, anxiety may be considered a marker of patient comorbidity in a complex patient population.

Indexed as

Abdominal WallAbdominoplastyAgedAnxietyChronic PainComorbidityDepressionFemaleHernia, VentralHerniorrhaphyHumansMaleMental DisordersMiddle AgedPlastic Surgery ProceduresTreatment OutcomeAnxietyAnxiolyticsHerniaVentral hernia

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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.