Age is just a number: The role of advanced age in predicting complications following ventral hernia repair with component separation

Background: While advanced age is often considered a risk factor for complications following abdominal surgery, its impact on outcomes after complex open ventral hernia repair (VHR) with component separation technique (CST) remains unclear. Methods: A single-center retrospective review of patients who VHR with CST from November 2008 to January 2022 was performed and cohorts were stratified by presence of advanced age (>= 60 years). Results: Of 219 patients who underwent VHR with CST, 114 patients (52.1 %) were aged >= 60 years. Multivariate analysis demonstrated BMI to be an independent predictor for any complication (OR 1.1, p = 0.002) and COPD was positively associated with seroma development (OR 20.1, p = 0.012). Advanced age did not independently predict postoperative outcomes, including hernia recurrence (OR 0.8, p = 0.766). Conclusions: VHR with CST is generally safe to perform in patients of advanced age. Every patient's comorbidity profile should be thoroughly assessed preoperatively for risk stratification regardless of age.