Risky lifestyle factors among patients scheduled for ventral hernia repair: a cross-sectional study of smoking, nutrition, alcohol, and physical inactivity (SNAP)

Abstract Background Risky lifestyle factors, including Smoking, Nutrition (malnutrition and obesity), risky Alcohol intake, and Physical inactivity (SNAP factors), are well-established predictors of postoperative complications. While advances such as Enhanced Recovery After Surgery have improved perioperative care, evidence on preoperative risk factor optimisation remains limited, particularly in hernia surgery. The aim was to map the prevalence of SNAP factors in patients undergoing ventral hernia repair and to estimate the potential impact of targeted preoperative intervention. Methods This cross-sectional study included patients aged ≥ 18 years scheduled for primary or incisional ventral hernia repair at two Danish university hospitals (March 2024–May 2025). Data on SNAP factors were obtained through structured interviews (by telephone or at the outpatient clinic) and review of health records. The prevalence of risky lifestyle factors was analysed with 95% confidence intervals, and hypothetical scenarios were modelled to estimate the potential impact of targeted prehabilitation. Results A total of 304 participants were included. Overall, 50% [95% CI 44–56%] had at least one SNAP factor with obesity (32% [27–37%]), smoking (14% [11–19%]), and risky alcohol intake (9% [6–13%]) being the most common. A subset of patients (12% [9–16%]) exhibited two or more coexisting SNAP factors. Age ≥ 65 years was associated with a significantly higher prevalence of SNAP factors in univariate (OR 1.66 [1.02–2.73]) and multivariable (OR 1.65 [1.01–2.72]) analyses. Conclusion Patients scheduled for ventral hernia repair frequently present with risky SNAP factors, particularly obesity and smoking. These findings highlight a major potential for risk factor reduction through targeted, multimodal prehabilitation in this population. Trial registration NCT06611462.