Evidence map›Paper›PMID 35962230›Full record

ArticleSurgical endoscopy2023

Variation of ventral and incisional hernia repairs in kidney transplant recipients.

Quintin P Solano, Jyothi R Thumma, Cody Mullens, Ryan Howard, Anne Ehlers, Lia Delaney, Brian Fry, Mary Shen, Michael Englesbe, Justin Dimick and 1 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Trial
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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

11 authors.

Quintin P SolanoUniversity of Michigan Medical School, Ann Arbor, MI, USA.ORCID 0000-0002-5195-8601
Jyothi R ThummaCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Cody MullensCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Ryan HowardCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Anne EhlersCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Lia DelaneyUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Brian FryCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Mary ShenCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Michael EnglesbeCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Justin DimickCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Dana TelemCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA. dtelem@med.umich.edu.

Funding

NRSA Training CoreTL1TR002242 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLINSTAT, MICHAEL ALLAN · 2017 to 2021
$2.8M
Obesity Surgery Scientist Training ProgramT32DK108740 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Justin Brigham Dimick, RANDY J SEELEY · 2016 to 2026
$2.2M
Developing and Implementing Evidence-Based Hernia CareK08HS025778 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI TELEM, DANA ALEXA · 2018 to 2021
$561k
AHRQ HHS K08 HS025778NCATS NIH HHS TL1 TR002242NIDDK NIH HHS T32 DK108740
6 · The paper itself

Abstract

introductionAs survivorship following kidney transplant continues to improve, so does the probability of intervening on common surgical conditions, such as ventral or incisional hernia, in this population. Ventral hernia management is known to vary across institutions and this variation has an impact on patient outcomes. We sought to evaluate hospital level variation of ventral or incisional hernia repair (VIHR) in the kidney transplant population.

methodsWe performed a retrospective review of 100% inpatient Medicare claims to identify patients who underwent kidney transplant between 2007 and 2018. The primary outcome was 1- and 3-year ventral or incisional risk- and reliability-adjusted VIHR rates. Patient and hospital characteristics were evaluated across risk- and reliability-adjusted VIHR rate tertiles. Models were adjusted for age, sex, race, and Elixhauser comorbidities.

resultsOverall, 139,741 patients underwent kidney transplant during the study period with a mean age (SD) of 51.6 (13.7) years. 84,717 (60.6%) were male, and 72,657 (52.0%) were white. Median follow up time was 5.4 years. 2098 (1.50%) patients underwent VIHR. the 1 year risk- and reliability-adjusted hernia repair rates were 0.49% (95% Conf idence Interval (CI) 0.48-0.51, range 0.31-0.59) in tertile 1, 0.63% (95% CI 0.62-0.63, range 0.59-0.68) in tertile 2, and 0.98 (95% CI 0.91-1.05, range 0.68-2.94) in tertile 3. Accordingly, compared to hospitals in tertile 1, the odds of post-transplant hernia repair tertile 2 hospitals were 1.78 (95% CI 1.37-2.31) and at tertile 3 hospitals 3.53 (95% CI 2.87-4.33).

conclusionsIn a large cohort of Medicare patients undergoing kidney transplant, the overall cumulative incidence of hernia repair varied substantially across hospital tertiles. Patient and hospital characteristics varied across tertile, most notably in diabetes and obesity. Future research is needed to understand if program and surgeon level factors are contributing to the observed variation in treatment of this common disease.

Indexed as

Hernia, VentralIncisional HerniaKidney TransplantationAgedFemaleHerniorrhaphyHumansMaleMedicareMiddle AgedReproducibility of ResultsRetrospective StudiesSurgical MeshUnited StatesHospital variationIncisional herniaTransplantVentral hernia repair

Identifiers

PMID35962230

What OpenQuestion holds

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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.