Management of umbilical hernias in patients with ascites: development of a nomogram to predict mortality

BackgroundThe objective of this study was to develop an easy-to-use nomogram to assist clinicians in predicting patient-specific mortality in this patient population.MethodsAmerican College of Surgeons National Surgical Quality Improvement Program participant use files were used from 2005 to 2011. Multivariable logistic regression was used to model 30-day postoperative mortality in patients with ascites who underwent umbilical hernia repair.ResultsA total of 688 patients with ascites undergoing umbilical hernia repair were included. There were 643 (94%) survivors and 45 (7%) mortalities. A total of 300 (44%) patients were classified as emergent cases. Using logistic regression to predict 30-day mortality, preoperative Model for End-Stage Liver Disease score, albumin, white blood cell count, and platelet count were found to be significant predictors (P < .05) of mortality and were included in our model.ConclusionWe propose a nomogram to enable clinicians to better estimate mortality in patients with ascites undergoing umbilical hernia repair.