Skip to main content
SpringerLink
Log in

Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County, MN

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

The relationship between body mass index (BMI) and the risk of inguinal hernia development is unclear. To explore the relationship, we determined whether the incidence of inguinal hernia repairs (IHR) varied across patients with different BMI categories.

Study Design

A population-based incidence study was undertaken. We reviewed all IHR performed on adult residents of Olmsted County, MN from 2004 to 2008. Cases were ascertained through the Rochester Epidemiology Project, a records-linkage system with more than 97 % population coverage.

Results

During the study period, a total of 1,168 IHR were performed on 879 men and 107 women. The median BMI of the cohort was 26.7 kg/m2 (range 14.9–58.1, interquartile range 23.9–28.9). Incidence rates varied significantly as a function of BMI (p < 0.001). Rates were highest among men who were either normal weight or overweight (419.8 and 421.1 per 100,000 person–years for BMI < 25 and BMI 25–29.9, respectively), and lowest for obese and morbidly obese men (273.5 and 99.4 per 100,000 person–years for BMI 30–34.9 and BMI ≥ 35, respectively). Findings were similar across all age categories and in patients who had an IHR that was initial or recurrent, direct or indirect, and unilateral or bilateral.

Conclusions

The incidence of IHR decreased as BMI increased. Obese and morbidly obese patients had a lower incidence of IHR than those who were normal weight or overweight. The causal mechanisms leading to such a relationship are unclear and warrant further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

IH:

Inguinal hernia

IHR:

Inguinal hernia repair

BMI:

Body mass index

REP:

Rochester Epidemiology Project

USA:

United States of America

H-ICDA:

Hospital adaptation of international classification of diseases

ICD-9:

International classification of diseases, 9th edition

CPT:

Current procedural terminology

NHANES:

National Health and Nutrition Examination Survey

References

  1. Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surgical Clinics of N. Am 83:1045–1051. doi:10.1016/S0039-6109(03)00132-4 v–vi

    Article  Google Scholar 

  2. Zendejas B, Ramirez T, Jones T et al (2013) Incidence of Inguinal Hernia Repairs in Olmsted County, MN: a Population-Based Study. Ann Surg 257:520–526. doi:10.1097/SLA.0b013e31826d41c6

    Article  PubMed Central  PubMed  Google Scholar 

  3. Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165:1154–1161. doi:10.1093/aje/kwm011

    Article  PubMed  Google Scholar 

  4. Noblett KL, Jensen JK, Ostergard DR (1997) The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. International Urogynecology J N.a. Floor Dysfunct. 8:323–326. doi:10.1007/BF02765589

    Article  CAS  Google Scholar 

  5. Varela JE, Hinojosa M, Nguyen N (2009) Correlations between intra-abdominal pressure and obesity-related co-morbidities. Surgery for Obes. Relat. diseases: official journal of the American Society for Bariatric Surgery 5:524–528. doi:10.1016/j.soard.2009.04.003

    Article  Google Scholar 

  6. Rosemar A, Angerås U, Rosengren A, Nordin P (2010) Effect of body mass index on groin hernia surgery. Ann Surg 252:397–401. doi:10.1097/SLA.0b013e3181e985a1

    Article  PubMed  Google Scholar 

  7. Rosemar A, Angerås U, Rosengren A (2008) Body mass index and groin hernia: a 34-year follow-up study in Swedish men. Ann Surg 247:1064–1068. doi:10.1097/SLA.0b013e31816b4399

    Article  PubMed  Google Scholar 

  8. Liem MS, Van der Graaf Y, Zwart RC et al (1997) Risk factors for inguinal hernia in women: a case-control study. The Coala Trial Group. Am J Epidemiol 146:721–726

    Article  PubMed  CAS  Google Scholar 

  9. Wang Y, Beydoun MA (2007) The obesity epidemic in the United States–gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev 29:6–28. doi:10.1093/epirev/mxm007

    Article  PubMed  CAS  Google Scholar 

  10. US Census Bureau (2011) http://www.census.gov Accessed 20 Aug 2011

  11. Melton LJI (1996) History of the Rochester Epidemiology Project. Mayo Clin Proc 71:266–274

    Article  PubMed  Google Scholar 

  12. St Sauver JL, Grossardt BR, Yawn BP et al (2011) Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester epidemiology project. Am J Epidemiol 173:1059–1068. doi:10.1093/aje/kwq482

    Article  PubMed Central  PubMed  Google Scholar 

  13. Commission on Professional and Hospital Activities (1973) H-ICDA. Hospital Adaptation of ICDA, Ann Arbor, MI

    Google Scholar 

  14. Centers for Disease Control and Prevention Classification of Diseases (2011) Functioning, and Disability. http://www.cdc.gov/nchs/icd.htm Accessed 20 Aug 2011

  15. American Medical Association Current Procedural Terminology (2011) http://www.ama-assn.org Accessed 20 Aug 2011

  16. Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. doi:10.1016/j.jbi.2008.08.010

    Article  PubMed Central  PubMed  Google Scholar 

  17. World Health Organization BMI Classification (2013) http://apps.who.int/bmi/index.jsp?introPage=intro_3.html Accessed 3 Apr 2013

  18. Lilja M, Eliasson M, Stegmayr B, et al. (2008) Trends in obesity and its distribution: data from the Northern Sweden MONICA Survey, 1986–2004. Obesity (Silver Spring, Md) 16:1120–1128. doi: 10.1038/oby.2008.230

  19. Lindström D, Sadr Azodi O, Bellocco R et al (2007) The effect of tobacco consumption and body mass index on complications and hospital stay after inguinal hernia surgery. Hernia: j of hernias and abdominal wall surgery 11:117–123. doi:10.1007/s10029-006-0173-4

    Article  Google Scholar 

  20. Carbonell JF, Sanchez JL, Peris RT et al (1993) Risk factors associated with inguinal hernias: a case control study. European j of surgery 159:481–486

    CAS  Google Scholar 

  21. Lambert DM, Marceau S, Forse RA (2005) Intra-abdominal pressure in the morbidly obese. Obes Surg 15:1225–1232. doi:10.1381/096089205774512546

    Article  PubMed  Google Scholar 

  22. St Sauver JL, Grossardt BR, Leibson CL et al (2012) Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project. Mayo Clinic proceedings Mayo Clinic 87:151–160. doi:10.1016/j.mayocp.2011.11.009

    Article  Google Scholar 

  23. Zendejas B, Ramirez T, Jones T et al (2012) Trends in the utilization of inguinal hernia repair techniques: a population-based study. Am J Surg 203:1–5. doi:10.1016/j.amjsurg.2011.10.005

    Article  Google Scholar 

Download references

Acknowledgments

This publication was made possible by the Rochester Epidemiology Project (Grant Number R01 AG034676 from the National Institute on Aging) and by Grant Number 1 UL1 RR024150 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.

Conflict of interest

BZ, TR, RH, CL, BG, and DF declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, College of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    B. Zendejas, R. Hernandez-Irizarry, T. Ramirez & D. R. Farley

  2. Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA

    C. M. Lohse & B. R. Grossardt

Authors
  1. B. Zendejas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Hernandez-Irizarry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Ramirez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. M. Lohse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. R. Grossardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. R. Farley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. R. Farley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zendejas, B., Hernandez-Irizarry, R., Ramirez, T. et al. Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County, MN. Hernia 18, 283–288 (2014). https://doi.org/10.1007/s10029-013-1185-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-013-1185-5

Keywords

Search

Navigation