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

- This study assesses the total number of open surgeries publicly available through NIS from 2009 to 2013.
- The prevalence of incisional hernia repair available in this same database from 2009 to 2013.
- A keen focus on comorbidities associated with each discharge grouping.
- Open surgeries are decreasing across specialties, while incisional hernia repair increases.
- An epidemiologic scope of open surgical discharges in the United States.

IntroductionIncisional 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 methodsUsing the 2009-2013 NIS, a cross-sectional review of hospital discharges associated with an open abdominal surgery was performed.ResultsBetween 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%).ConclusionsOur 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.