Pain outcomes in emergent versus elective ventral hernia repair: Propensity score matched analysis.

IF 2.7 2区医学 Q1 SURGERY

Hernia Pub Date : 2026-10-01 DOI:10.1007/s10029-026-03842-0

Sidhant Kalsotra, Li-Ching Huang, Savannah Renshaw, Benjamin K Poulose

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引用次数: 0

Abstract

Introduction: Whether emergent ventral hernia repair (VHR) compromises long-term patient-reported pain recovery compared to elective repair remains unknown. We compared Patient-Reported Outcomes Measurement Information System Pain Intensity (PROMIS Pain 3a) outcomes between emergent and elective VHR using a multicenter registry after risk adjustment.

Methods: We performed a retrospective cohort analysis using the Abdominal Core Health Quality Collaborative (ACHQC) registry of adults undergoing VHR from 2013 to 2024 with complete baseline and 30-day PROMIS Pain 3a scores were included. Emergent and elective repairs were compared using 1:3 propensity score matching (PSM) across 31 covariates. The primary outcome was PROMIS Pain 3a T-score at one year postoperatively.

Results: Of 11,831 patients (94 emergent, 11,737 elective), emergent patients had higher baseline PROMIS Pain 3a T-scores (median 52 [IQR 46-58] vs. 44 [IQR 36-52], p < 0.001), BMI (median 36 [IQR 32-41] vs. 31 [IQR 27-36] kg/m², p < 0.001), and ASA class 3-4 rates (66% vs. 55%, p < 0.001). After PSM (71 emergent, 193 elective), baseline pain scores were equivalent (median 52 [IQR 44-58] vs. 49 [IQR 44-54], p = 0.2). At 30 days, pain scores did not differ (median 44 [IQR 40-52] vs. 46 [IQR 40-52], p = 0.6). At one year, emergent patients reported significantly lower PROMIS Pain 3a T-scores (median 31 [IQR 31-38] vs. 40 [IQR 31-46], p = 0.01) and greater improvement from baseline (median - 21 [IQR - 24 to - 11] vs. -8 [IQR - 16 to 0], p = 0.002). Complication rates and pragmatic recurrence through five years were equivalent between matched groups.

Conclusion: Emergent VHR patients demonstrated superior patient-reported pain outcomes at one year compared to propensity-matched elective controls, with equivalent complication and recurrence rates. These findings challenge the notion that emergent repairs inherently lead to worse outcomes and suggest that surgical urgency may not negatively impact long-term pain recovery.

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急诊与择期腹疝修复的疼痛结果：倾向评分匹配分析。

简介：与选择性修复相比，急诊腹疝修复（VHR）是否会损害患者报告的长期疼痛恢复仍然未知。我们在风险调整后使用多中心注册比较了患者报告的结果测量信息系统疼痛强度（PROMIS Pain 3a）在急诊和选择性VHR之间的结果。方法：我们使用腹部核心健康质量协作（ACHQC）注册表对2013年至2024年接受VHR的成年人进行回顾性队列分析，包括完整基线和30天PROMIS疼痛3a评分。在31个协变量中使用1:3倾向评分匹配（PSM）比较紧急修复和选择性修复。主要终点为术后1年的PROMIS Pain 3a t评分。结果：在11,831例患者中（94例急诊患者，11,737例非急诊患者），急诊患者具有更高的基线PROMIS Pain 3a t评分(中位数为52 [IQR 46-58]对44 [IQR 36-52]， p结论：与倾向匹配的选择性对照组相比，急诊VHR患者在一年内表现出更好的患者报告的疼痛结局，并发症和复发率相当。这些发现挑战了紧急修复本身会导致更糟糕结果的观念，并表明手术紧迫性可能不会对长期疼痛恢复产生负面影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.