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1 Supplementary Online Content Won EJ, Lehman EB, Geletzke AK, et al. Association of postoperative hyperglycemia with outcomes among patients with complex ventral hernia repair. JAMA Surg. Published online March 18, doi: /jamasurg etable 1. Significant Preoperative and Intraoperative Attributes as Independent Predictors of Outcome Using 2 Different Procedures etable 2. Risk Factors Associated With Postoperative Hyperglycemia (Serum Glucose Level 140 mg/dl) etable 3. Outcomes Based on VHWG Hernia Grades with Breakdown by SSO Type etable 4. Comparison of Patients in Study Group and Patients Excluded (Serum Glucose Level Not Recorded) 2015 American Medical Association. All rights reserved. 1

2 etable 1. Significant Preoperative and Intraoperative Attributes as Independent Predictors of Outcome Using 2 Different Procedures Full Model Time to First Meal Length of Stay Total Cost SSO Duration of procedure P < P < P < P = No. insulin events P = P = P = X Pre-op corticosteroids P = X X X Use of mesh P = X X X Component separation X P = P = X Age X X X P = Reduced Model Duration of procedure P < P < P < P = No. insulin events P = P = P < X Pre-op corticosteroids P = X X X Component separation X X P = X Age X X X P = Use of mesh P = X X X Pre-operative diagnosis of diabetes X X X P = *All variables from the Full & Reduced Models included as independent variables in the full model for each outcome variable. Only variables with P < 0.10 are listed. **Significant variables remaining after a process of stepwise elimination using P = 0.10 as criteria for staying in the reduced model American Medical Association. All rights reserved. 2

3 etable 2. Risk Factors Associated with Postoperative Hyperglycemia (Serum Glucose Level 140 mg/dl) Variable Post-op Serum BG 140 mg/dl (n=54) Post-op Serum BG 140 mg/dl (n=82) OR (95% Cl) P-value* Age at surgery (10 years) mean ± 59.0 ± ± (0.97, 1.66) SD BMI (5 kg/m2) mean ± SD 37.1 ± ± (1.23, 2.26) Procedure duration (10 min) mean ± ± (1.01, 1.07) ± SD ASA class (1 or 2), n (%) 1 or 2 14 (25.0) 42 (52.5) 3.32 (1.57, 7.0) or 4 42 (75.0) 38 (47.5) Active tobacco use, n (%) Yes 5 (8.9) 12 (15.0) 0.56 (0.18, 1.68) No 51 (91.1) 68 (85.0) CAD, n(%) Yes 6 (10.7) 12 (15.0) 0.68 (0.24, 1.94) No 50 (89.3) 68 (85.0) HTN, n(%) Yes 41 (73.2) 44 (55.0) 2.24 (1.07, 4.67) No 15 (26.8) 36 (45.0) Pre-op oral hypoglycemic use, n(%) Yes 11 (19.6) 2 (2.5) 9.53 (2.02, 44.94) No 45 (80.4) 78 (97.5) Post-op insulin use within 96 hours after surgery, n (%) Yes 41 (73.2) 30 (37.5) 4.56 (2.16, 9.59) < No 15 (26.8) 50 (62.5) No. of insulin events (1 event) mean ± SD 4.0 ± ± (1.10, 1.42) Peri-operative dexamethasone use, n (%) Yes 26 (46.4) 32 (40.0) 1.30 (0.65, 2.59) No 30 (53.6) 48 (60.0) *Logistic regression is used for all variables as potential predictors of post-op hyperglycemia. Reference units are provided for continuous variables American Medical Association. All rights reserved. 3

4 etable 3. Outcomes Based on VHWG Hernia Grades With Breakdown by SSO Type Grade Number of patients Age 63.6 ± ± ± ± 16.3 Male:Female 4:4 33:46 26:15 4:4 Number of BMI>30 0 (0) 71 (89.9) 29 (70.7) 7 (87.5) Number of known diabetics 0 (0) 31 (39.2) 6 (14.6) 5 (62.5) Mean 1 st POG (mean ± SD) ± ± ± ± 44.8 Number of patients needing insulin 4 (50) 41 (52) 17 (41) 7(88) Number of patients with 3 insulin 1 (12.5) 28 (35.4) 14 (34.2) 4 (50.0) events Duration of ileus 5 days 3 (37.5) 24 (30.4) 21 (51.2) 5 (62.5) LOS 6 days 4 (50.0) 36 (45.6) 23 (56.1) 6 (75.0) Total costs $25,000 2 (25.0) 27 (34.2) 19 (46.3) 7 (87.5) SSO 0 (0) 21 (26.6) 13 (31.7) 5 (62.5) 1 st POG < 140 mg/dl Patients with SSO 0 (0) 9 (20.0) 8 (29.6) 1 (33.3) Seroma 0 (0) 6 (13.3) 3 (11.1) 0 (0) Hematoma 0 (0) 1 (2.2) 2 (7.4) 0 (0) Surgical site infection 0 (0) 3 (6.7) 3 (11.1) 1 (33.3) Non-healing wound 0 (0) 4 (8.9) 2 (7.4) 0 (0) Recurrence 0 (0) 0 (0) 0 (0) 0 (0) 1 st POG > 140 mg/dl Patients with SSO 0 (0) 12 (35.3) 5 (35.7) 4 (80.0) Seroma 0 (0) 5 (14.7) 1 (7.1) 1 (20.0) Hematoma 0 (0) 0 (0) 0 (0) 0 (0) Surgical site infection 0 (0) 4 (11.8) 2 (14.3) 2 (40.0) Non-healing wound 0 (0) 3 (8.8) 2 (14.3) 2 (40.0) Recurrence 0 (0) 2 (5.9) 0 (0) 1 (20.0) Patients < 2 insulin events SSO 0 (0) 8 (20.5) 6 (26.1) 1(50.0) Seroma 0 (0) 4 (10) 3 (13.0) 1 (50) Hematoma 0 (0) 1 (2.6) 2 (8.7) 0 (0) Surgical site infection 0 (0) 2 (5.1) 1 (4.4) 0 (0) Non-healing wound 0 (0) 1 (2.6) 1 (4.4) 0 (0) Recurrence 0 (0) 2 (5.1) 0 (0) 0 (0) Patients 2 insulin events SSO 0 (0) 13 (32.5) 7 (38.9) 4 (66.7) Seroma 0 (0) 7 (17.5) 1 (5.6) 0 (0) Hematoma 0 (0) 0 (0) 0 (0) 0 (0) Surgical site infection 0 (0) 5 (12.5) 4 (22.2) 3 (50.0) Non-healing wound 0 (0) 6 (15.0) 3 (16.7) 2 (33.3) Recurrence 0 (0) 0 (0) 0 (0) 1 (16.7) *Data presented as N, N (%), or mean ± SD American Medical Association. All rights reserved. 4

5 etable 4. Comparison of Patients in Study Group and Patients Excluded (Serum Glucose Level Not Recorded) Variable Glucose Recorded (n = 136) No Glucose Recorded (n = P-value* 36) Age (years), mean + SD BMI (kg/m 2 ) mean + SD Diabetic, n (%) Yes 42 (30.9) 2 (5.6) No 94 (69.1) 34 (94.4) CAD, n (%) Yes 18 (13.2) 0 (0) No 118 (86.8) 36 (100) HTN, n (%) Yes 85 (62.5) 16 (44.4) No 51 (37.5) 20 (55.6) Grade, n (%) I 8 (5.9) 7 (19.4) II 79 (58.1) 18 (50.0) III 41 (30.1) 9 (25.0) IV 8 (5.9) 2 (5.6%) Procedure duration, < (min) mean + SD LOS (days) < mean + SD SSO, n (%) 39 (28.7) 6 (16.7) *All continuous variables are analyzed with a Wilcoxon Rank Sum test while all categorical variables are analyzed with a Chi-square test American Medical Association. All rights reserved. 5

Supplementary Online Content

Supplementary Online Content Abt NB, Flores JM, Baltodano PA, et al. Neoadjuvant chemotherapy and short-term in patients undergoing mastectomy with and without breast reconstruction. JAMA Surg. Published