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High complication and mortality rates after emergency groin hernia repair: a nationwide register-based cohort study

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Abstract

Purpose

Emergency groin hernia is an understudied research field despite its severity requiring emergency surgery associated with high postoperative morbidity and mortality rates. Therefore, this study aimed to investigate the characteristics of patients, hernias, and surgical repairs, as well as complication rates following emergency groin hernia repair.

Methods

Nationwide cohort study based on prospectively collected data obtained from the Danish Hernia Database and person-level linked to the Danish National Patient Registry. We included all adult patients undergoing an emergency groin hernia repair for inguinal- and/or femoral hernias registered in the Danish Hernia Database between January 1, 1998, and December 31, 2020. Primary outcomes were 30- and 90-day mortality, 30- and 90-day readmissions, and reoperations for recurrence. Outcomes were presented as crude numbers, odds ratios for mortality and readmission, and hazard ratios for reoperation.

Results

We included 9741 patients in the study. Within 30 days of surgery, 510 (6%) deaths and 1800 (23%) readmissions were recorded. During a median follow-up of 5 years, 537 (6%) reoperations for recurrence were performed. Multivariate analyses showed that mortality and readmission rates were influenced by increasing age, comorbidity, and bowel resection. Cumulative and adjusted reoperation rates were lower for mesh than non-mesh repairs. Moreover, mortality rates have improved over time, whereas readmission rates have increased over time.

Conclusions

Complication and mortality rates after emergency groin hernia repair remain high. This study underlines the importance of a timely repair in incarcerated hernias to avoid contaminated surgical fields and the need for bowel resection.

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Acknowledgements

Ann Hou Sæter has received research funding from The Copenhagen Medical Society and the Research Council of Herlev and Gentofte Hospitals, which had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Ann Hou Sæter BSc, Siv Fonnes MD, PhD, Jacob Rosenberg MD, DMSc & Kristoffer Andresen MD, PhD

Authors
  1. Ann Hou Sæter BSc
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  2. Siv Fonnes MD, PhD
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  3. Jacob Rosenberg MD, DMSc
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  4. Kristoffer Andresen MD, PhD
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AHS. The first draft of the manuscript was written by AHS, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Ann Hou Sæter BSc.

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Conflict of interest

This study has received research funding from the Copenhagen Medical Society and the Research Council of Herlev and Gentofte Hospitals, which had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Ethical approval

This study received approval from the Danish Data Protection Agency (journal no. P-2021-210). According to Danish law, ethical approval was not required.

Human and animal rights

Not applicable.

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Not required, according to Danish law.

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Not required, according to Danish law.

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Sæter, A.H., Fonnes, S., Rosenberg, J. et al. High complication and mortality rates after emergency groin hernia repair: a nationwide register-based cohort study. Hernia 26, 1131–1141 (2022). https://doi.org/10.1007/s10029-022-02597-8

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  • DOI: https://doi.org/10.1007/s10029-022-02597-8

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