To investigate the risk factors of recurrence after abdominal wall incisional hernia repair in elderly patients, and to establish a risk nomogram model for predicting recurrence after abdominal wall incisional hernia repair in elderly patients.

A total of 260 elderly patients with abdominal wall incisional hernia repair who were diagnosed and treated in the Drum Tower Hospital Affiliated with Nanjing University from January 2014 to December 2019 were selected as the research subjects. For the recurrence group and the normal group, logistic regression analysis was used to screen the risk factors of recurrence after abdominal wall incisional hernia repair in elderly patients, and a nomogram model for the risk of recurrence after abdominal wall incisional hernia repair in elderly patients was established.

Among the 260 elderly patients with abdominal wall incisional hernia repair, 36 patients (13.85%) had postoperative recurrence. Univariate analysis showed that there was no significant difference in gender, age, hernia type, hernia location, patch type, fixed patch, operation type, and drinking history between the recurrence group and the normal group (P>0.05), while there were significant differences in operation time, physician level, postoperative hematoma, smoking history and obesity (P<0.05). Logistic regression analysis showed that operation time ≥120 minutes, physician level, postoperative hematoma, smoking history and obesity were independent risk factors for recurrence after abdominal wall incisional hernia repair in elderly patients (P<0.05), and both were highly correlated with the recurrence after incisional abdominal wall hernia repair in elderly patients. Based on the independent risk factors for recurrence after abdominal wall incisional hernia repair in elderly patients, such as operation time, physician level, postoperative hematoma, smoking history, and obesity, a nomogram model was established to predict the risk of recurrence after abdominal wall incisional hernia repair in elderly patients. The C-index was 0.775 (95% CI: 0.728-0.823), and the predicted value was basically the same as the measured value, indicating that the nomogram had better discrimination ability, and the nomogram model predicted the recurrence of elderly patients with abdominal wall incisional hernia repair. The operator operating characteristic curve shows that the area under the curve is 0.807, indicating that the nomogram in this study has a high predictive value.

Operation time ≥120 minutes, physician level, postoperative hematoma, smoking history and obesity are independent risk factors for recurrence after abdominal wall incisional hernia repair in elderly patients. The nomogram established in this study can help predict the abdominal wall of elderly patients. The risk of recurrence after incisional hernia repair.