Trends in open abdominal surgery in the United States-Observations from 9,950,759 discharges using the 2009-2013 National Inpatient Sample (NIS) datasets

Introduction: Incisional hernia (IH) represents a complex and costly surgical complication. We aim to address trends in open surgery to better understand potential drivers of hernia risk. Material and methods: Using the 2009-2013 NIS, a cross-sectional review of hospital discharges associated with an open abdominal surgery was performed. Results: Between 2009 and 2013, there were nearly 10 million discharges associated with an open abdominal surgery. Overall, there were 2,140,616 patients receiving open surgery in 2009, decreasing to 1,760,549 in 2013 (18% decrease, p < 0.001). Open hernia procedures increased from 37,325 patients in 2009 to 41,845 in 2013 (12% increase, p = 0.001). The most prevalent comorbidities within this population included uncomplicated hypertension (25.26%), chronic pulmonary diseases (13.52%), obesity (10.24%), uncomplicated diabetes (11.06%), and depression (10.72%). Conclusions: Our analysis allowed for a unique view of surgical trends, health care population dynamics, and an opportunity to use evidence-driven analytics in the understanding of IH. (C) 2017 Elsevier Inc. All rights reserved.