Hospital and surgeon variation in 30-day complication rates after ventral hernia repair.

BACKGROUND: Ventral hernia repair is an extremely common operation, however the variability in patient outcomes between individual hospitals and surgeons is unclear. We analyzed variability in 30-day complication rates and identified specific complications that contributed to this variability.

METHODS: Retrospective, cross-sectional analysis of 30-day complication rates following ventral hernia repair across 73 hospital and 978 surgeons between January 1, 2014 and December 31, 2018.

RESULTS: Data were collected on 19,007 patients who underwent VIHR at 73 hospitals across 978 surgeons. Adjusted complication rate among hospitals was 6.2% (range 4.3%-12.8%) and among surgeons was 6.2% (range 3.5%-26.8%). Variation between lowest and highest quartile surgeons was greatest for acute kidney injury (0.12% vs. 1.71%, P < 0.001), superficial surgical site infection (0.33% vs. 3.62%, P < 0.001), sepsis (0.27% vs. 2.47%, P < 0.001), and catheter-associated urinary tract infection (0.02% vs. 0.30%, P < 0.001).

CONCLUSION: After adjusting for a number of patient-specific clinical variables, there is significant variation in 30-day complication rates after ventral hernia repair. This represents a significant opportunity to improve patient outcomes.