Risk factors associated with local postoperative complications in patients with complex incisional hernia: a case-control study
Valeria Grageda Gómez- José Augusto Rodríguez Osuna
- Josué Israel Olivares del Moral
- Jonathan Dazaeth Delgado Sánchez
- Ana María Tiscareño Guzman
Published 2026-10-30
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Abstract
Objective: To analyse the risk factors associated with local postoperative complications in patients with large incisional hernias (≥ 10 cm) treated at Centenario Hospital Miguel Hidalgo between 2018 and 2024.
Materials and Methods: A retrospective, casecontrol study was conducted. A total of 148 patients were included: 74 cases (with local complications: seroma, surgical site infection, haematoma, dehiscence) and 74 controls (without complications). Multivariable logistic regression was used to identify independent risk factors.
Results: The most frequent complication was seroma (43.2%). Independent risk factors were: age ≥ 75 years (OR 5.27; 95% CI 1.3520.55; p = 0.016), current smoking (OR 5.23; 95% CI 2.1912.50; p < 0.001), and hernia sac size ≥ 6 cm (OR 3.59; 95% CI 1.697.62; p = 0.001). Hypertension showed an inverse association (OR 0.16; 95% CI 0.040.63; p = 0.007) and prehabilitation was protective (OR 0.22; 95% CI 0.090.54; p = 0.001). The area under the ROC curve was 0.804 (95% CI 0.7340.874).
Discussion: Advanced age, smoking and larger hernia sac size are risk factors that should be considered in preoperative planning. Prehabilitation significantly reduces complications.
Conclusion: Age ≥ 75 years, current smoking and sac size ≥ 6 cm are independent risk factors for local complications after large inci-sional hernia repair. Prehabilitation is protective and should be part of preoperative optimisation.