Pre-existing comorbidities significantly impact surgery results for hernia repairs.

• Six comorbidity profiles were identified in over 224,500 patients, including smoking and heart failure.
• Patients with bleeding disorders or congestive heart failure faced a 3.22 times higher 30-day mortality risk.
• Surgical outcomes and hospital stays worsen with most comorbidity clusters.

Incorporating these profiles into preoperative assessments can guide targeted interventions and enhance decision-making for high-risk patients.