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Serious adverse events within 30 days of groin hernia surgery

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Abstract

Purpose

To analyze severe complications after groin hernia repair with respect to age, ASA score, hernia anatomy, method of repair and method of anesthesia, using nationwide registers.

Summary background data

The annual rate of 20 million groin hernia operations throughout the world renders severe complications, although rare, important both for the patient, the clinician, and the health economist.

Methods

Two nationwide registers, the Swedish Hernia Register and the National Swedish Patient Register were linked to find intraoperative complications, severe cardiovascular events and severe surgical adverse events within 30 days of groin hernia surgery.

Results

143,042 patients, 8 % women and 92 % men, were registered between 2002 and 2011. Intraoperative complications occurred in 801 repair, 592 patients suffered from cardiovascular events and 284 patients from a severe surgical event within 30 days of groin hernia surgery. Emergency operation was a risk factor for both cardiovascular and severe surgical adverse events with odds ratios for cardiovascular events of 3.1 (2.5–4.0) for men and 2.8 (1.4–5.5) for women. Regional anesthesia was associated with an increase in cardiovascular morbidity compared with local anesthesia, odds ratio 1.4 (1.1–1.9). In men, bilateral hernia and sliding hernia approximately doubled the risk for severe surgical events; odds ratio 1.9 (1.1–3.5) and 2.2 (1.6–3.0), respectively. Methods other than open anterior mesh repair increased the risk for surgical complications.

Conclusions

Awareness of the increased risk for cardiovascular or surgical complications associated with emergency surgery, bilateral hernia, sliding hernia, and regional anesthesia may enable the surgeon to further reduce their incidence.

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Acknowledgments

The above paper is an original study, not previously published, however, included in a thesis: Mortality and Morbidity after groin hernia surgery—the role of nationwide registers in finding and analyzing rare outcomes. ISBN:978-91-7459-755-4. Neither one of the authors stated above have any financial or personal relationships that could inappropriately influence the author’s decisions, work, or manuscript.

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Authors and Affiliations

  1. Department of Surgical and Perioperative Science, Umeå University, 901 85, Umeå, Sweden

    H. Nilsson & P. Nordin

  2. Department of Surgery, Sahlgrenska University Hospital/Östra, Östra Sjukhuset, 416 85, Göteborg, Sweden

    H. Nilsson & U. Angerås

  3. Division of Surgery, CLINTEC, Karolinska institutet, Stockholm, Sweden

    G. Sandblom

Authors
  1. H. Nilsson
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  2. U. Angerås
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  3. G. Sandblom
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  4. P. Nordin
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Corresponding author

Correspondence to H. Nilsson.

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HN declares no conflict of interest

GS declares no conflict of interest

UA declares no conflict of interest

PN declares no conflict of interest.

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Nilsson, H., Angerås, U., Sandblom, G. et al. Serious adverse events within 30 days of groin hernia surgery. Hernia 20, 377–385 (2016). https://doi.org/10.1007/s10029-016-1476-8

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  • DOI: https://doi.org/10.1007/s10029-016-1476-8

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