Complex abdominal wall hernia repair with biologic mesh in elderly: a propensity matched analysis.
BACKGROUND
Complex abdominal wall reconstruction (CAWR) has become a common surgical procedure both in non-elderly and elderly patients.


OBJECTIVE
The aim of this study is to analyze the outcomes of the elderly compared to nonelderly undergoing CAWR using propensity score matching.


METHODS
All patients who underwent CAWR using porcine-derived, non-crosslinked acellular dermal matrix (ADM) (Strattice™) between January 2014 and July 2017 were studied retrospectively. Propensity matched analysis was performed for risk adjustment in multivariable analysis and for one-to-one matching. The outcomes were analyzed for differences in postoperative complications, reoperations, mortality, hospital length of stay and adverse discharge disposition.


RESULTS
One hundred-thirty-six patients were identified during the study period. Non-elderly (aged 18-64 years) constituted 70% (n = 95) and elderly (aged ≥ 65 years) comprised 30% of the overall patient population (n = 41). Seventy-three (56.7%) were females. After adjustment through the propensity score, which included 35 pairs, the surgical site infection (p = 1.000), wound necrosis (p = 1.000), the need for mechanical ventilation (p = 0.259), mortality (p = 0.083), reoperation rate (p = 0.141), hospital length of stay (p = 0.206), and discharge disposition (p = 0.795) were similar.


CONCLUSION
Elderly patients undergoing CAWR with biological mesh have comparable outcomes with non-elderly patients when using propensity matching score.
['Gogna|S|S|0000-0002-4075-9674', 'Latifi|R|R|', 'Policastro|A|A|', 'Prabhakaran|K|K|', 'Anderson|P|P|', 'Con|J|J|', 'Choi|J|J|', 'Samson|D J|DJ|', 'Butler|J|J|']
D034861:Abdominal Wall D062088:Acellular Dermis D000293:Adolescent D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000818:Animals D001705:Bioprosthesis D005260:Female D006555:Hernia, Ventral D059685:Herniorrhaphy D006801:Humans D008297:Male D008875:Middle Aged D057216:Propensity Score D019651:Reconstructive Surgical Procedures D012086:Reoperation D012189:Retrospective Studies D020379:Risk Adjustment D013526:Surgical Mesh D055815:Young Adult
Hernia Biologic mesh Elderly Propensity matching Complex abdominal wall reconstruction Outcomes Complications Posterior component release