Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians
Background The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased...
Gespeichert in:
| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2013-12, Vol.17 (6), p.723-727 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 727 |
|---|---|
| container_issue | 6 |
| container_start_page | 723 |
| container_title | Hernia : the journal of hernias and abdominal wall surgery |
| container_volume | 17 |
| creator | Pallati, P. K. Gupta, P. K. Bichala, S. Gupta, H. Fang, X. Forse, R. A. |
| description | Background
The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased morbidity and mortality.
Study design
Patients aged 80 and above undergoing inguinal hernia repair were identified from the American College of Surgeons’ National Surgical Quality Improvement Program (2007–2008). Univariate analysis was performed using chi square, Fisher’s exact test and t test. Multivariate logistic regression analysis was carried out to assess factors associated with increased postoperative complications and mortality.
Results
Of 2,377 patients above 80 years of age, 226 (9.5 %) were nonagenarians. Men accounted for 81.4 % (1,936) of patients. There were significantly more female patients in the nonagenarian group (29.2 vs. 17.4 %,
p
|
| doi_str_mv | 10.1007/s10029-012-1040-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1461345406</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3132154811</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-b79ec9bf78150e9e0e4cb7d02109f7d0897c206eaab27f5a78e70c5fa981c5223</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OIlOslmN5ujFL-goKCeQzadbbd0k5rsHvz3prSKCF4yYfLMO-Qh5JzBNQOQNzGdXFFgnDIQQOGAjBkXFVUcxOH2XhZUKChH5CTGFQBUoqyOyYjnOUjgxZi8vC596GmPocv80FvfYcx8k7VuMbTOrLMlBteaLODGtCG1M297v0BnQmtczIybZ84789M5JUeNWUc829cJeb-_e5s-0tnzw9P0dkatyKue1lKhVXUjK1YAKgQUtpZz4AxUk2qlpOVQojE1l01hZIUSbNEYVTFbcJ5PyNUudxP8x4Cx110bLa7XxqEfomaiZLkoBJQJvfyDrvwQ0ue2VKGUkEyxRLEdZYOPMWCjN6HtTPjUDPRWt97p1km33urWkGYu9slD3eH8Z-LbbwL4DojpyS0w_Fr9b-oXXV6KBQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1459947191</pqid></control><display><type>article</type><title>Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Pallati, P. K. ; Gupta, P. K. ; Bichala, S. ; Gupta, H. ; Fang, X. ; Forse, R. A.</creator><creatorcontrib>Pallati, P. K. ; Gupta, P. K. ; Bichala, S. ; Gupta, H. ; Fang, X. ; Forse, R. A.</creatorcontrib><description>Background
The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased morbidity and mortality.
Study design
Patients aged 80 and above undergoing inguinal hernia repair were identified from the American College of Surgeons’ National Surgical Quality Improvement Program (2007–2008). Univariate analysis was performed using chi square, Fisher’s exact test and t test. Multivariate logistic regression analysis was carried out to assess factors associated with increased postoperative complications and mortality.
Results
Of 2,377 patients above 80 years of age, 226 (9.5 %) were nonagenarians. Men accounted for 81.4 % (1,936) of patients. There were significantly more female patients in the nonagenarian group (29.2 vs. 17.4 %,
p
< 0.0001). Laparoscopic repair was performed in 210 (9.9 %) patients. Emergency repair was more frequent in nonagenarians than octogenarians (12 vs. 4.4 %,
p
< 0.0001). The 30-day overall complication rate was significantly increased in nonagenarians compared to octogenarians (6.1 vs. 3.2 %,
p
= 0.03). Mortality is increased tenfold in elective inguinal hernia repair in nonagenarians compared to octogenarians (3 vs. 0.3 %,
p
< 0.0005). On multivariate analysis, preoperative variables found to be significantly associated with morbidity included totally dependent functional status, congestive heart failure and emergent nature of procedure, while higher age, emergency repair and open wound are associated with increased mortality.
Conclusions
Elective inguinal hernia repair can be safely performed in octogenarians with low morbidity and mortality but is increased in nonagenarians. More vigilant postoperative care is required after emergent hernia repairs due to the increased risk of morbidity and mortality, and effort should be made to electively repair inguinal hernias early in this elderly population.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-012-1040-0</identifier><identifier>PMID: 23307025</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Age Factors ; Aged, 80 and over ; Databases, Factual ; Elective Surgical Procedures - mortality ; Female ; Hernia, Inguinal - surgery ; Herniorrhaphy - methods ; Herniorrhaphy - mortality ; Humans ; Laparoscopy ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Multivariate Analysis ; Original Article ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Recurrence ; Reoperation ; Risk Factors ; Treatment Outcome</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2013-12, Vol.17 (6), p.723-727</ispartof><rights>Springer-Verlag France 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-b79ec9bf78150e9e0e4cb7d02109f7d0897c206eaab27f5a78e70c5fa981c5223</citedby><cites>FETCH-LOGICAL-c438t-b79ec9bf78150e9e0e4cb7d02109f7d0897c206eaab27f5a78e70c5fa981c5223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-012-1040-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-012-1040-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23307025$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pallati, P. K.</creatorcontrib><creatorcontrib>Gupta, P. K.</creatorcontrib><creatorcontrib>Bichala, S.</creatorcontrib><creatorcontrib>Gupta, H.</creatorcontrib><creatorcontrib>Fang, X.</creatorcontrib><creatorcontrib>Forse, R. A.</creatorcontrib><title>Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Background
The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased morbidity and mortality.
Study design
Patients aged 80 and above undergoing inguinal hernia repair were identified from the American College of Surgeons’ National Surgical Quality Improvement Program (2007–2008). Univariate analysis was performed using chi square, Fisher’s exact test and t test. Multivariate logistic regression analysis was carried out to assess factors associated with increased postoperative complications and mortality.
Results
Of 2,377 patients above 80 years of age, 226 (9.5 %) were nonagenarians. Men accounted for 81.4 % (1,936) of patients. There were significantly more female patients in the nonagenarian group (29.2 vs. 17.4 %,
p
< 0.0001). Laparoscopic repair was performed in 210 (9.9 %) patients. Emergency repair was more frequent in nonagenarians than octogenarians (12 vs. 4.4 %,
p
< 0.0001). The 30-day overall complication rate was significantly increased in nonagenarians compared to octogenarians (6.1 vs. 3.2 %,
p
= 0.03). Mortality is increased tenfold in elective inguinal hernia repair in nonagenarians compared to octogenarians (3 vs. 0.3 %,
p
< 0.0005). On multivariate analysis, preoperative variables found to be significantly associated with morbidity included totally dependent functional status, congestive heart failure and emergent nature of procedure, while higher age, emergency repair and open wound are associated with increased mortality.
Conclusions
Elective inguinal hernia repair can be safely performed in octogenarians with low morbidity and mortality but is increased in nonagenarians. More vigilant postoperative care is required after emergent hernia repairs due to the increased risk of morbidity and mortality, and effort should be made to electively repair inguinal hernias early in this elderly population.</description><subject>Abdominal Surgery</subject><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Databases, Factual</subject><subject>Elective Surgical Procedures - mortality</subject><subject>Female</subject><subject>Hernia, Inguinal - surgery</subject><subject>Herniorrhaphy - methods</subject><subject>Herniorrhaphy - mortality</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate Analysis</subject><subject>Original Article</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Recurrence</subject><subject>Reoperation</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OIlOslmN5ujFL-goKCeQzadbbd0k5rsHvz3prSKCF4yYfLMO-Qh5JzBNQOQNzGdXFFgnDIQQOGAjBkXFVUcxOH2XhZUKChH5CTGFQBUoqyOyYjnOUjgxZi8vC596GmPocv80FvfYcx8k7VuMbTOrLMlBteaLODGtCG1M297v0BnQmtczIybZ84789M5JUeNWUc829cJeb-_e5s-0tnzw9P0dkatyKue1lKhVXUjK1YAKgQUtpZz4AxUk2qlpOVQojE1l01hZIUSbNEYVTFbcJ5PyNUudxP8x4Cx110bLa7XxqEfomaiZLkoBJQJvfyDrvwQ0ue2VKGUkEyxRLEdZYOPMWCjN6HtTPjUDPRWt97p1km33urWkGYu9slD3eH8Z-LbbwL4DojpyS0w_Fr9b-oXXV6KBQ</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Pallati, P. K.</creator><creator>Gupta, P. K.</creator><creator>Bichala, S.</creator><creator>Gupta, H.</creator><creator>Fang, X.</creator><creator>Forse, R. A.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians</title><author>Pallati, P. K. ; Gupta, P. K. ; Bichala, S. ; Gupta, H. ; Fang, X. ; Forse, R. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-b79ec9bf78150e9e0e4cb7d02109f7d0897c206eaab27f5a78e70c5fa981c5223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Surgery</topic><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Databases, Factual</topic><topic>Elective Surgical Procedures - mortality</topic><topic>Female</topic><topic>Hernia, Inguinal - surgery</topic><topic>Herniorrhaphy - methods</topic><topic>Herniorrhaphy - mortality</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate Analysis</topic><topic>Original Article</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Recurrence</topic><topic>Reoperation</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pallati, P. K.</creatorcontrib><creatorcontrib>Gupta, P. K.</creatorcontrib><creatorcontrib>Bichala, S.</creatorcontrib><creatorcontrib>Gupta, H.</creatorcontrib><creatorcontrib>Fang, X.</creatorcontrib><creatorcontrib>Forse, R. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pallati, P. K.</au><au>Gupta, P. K.</au><au>Bichala, S.</au><au>Gupta, H.</au><au>Fang, X.</au><au>Forse, R. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>17</volume><issue>6</issue><spage>723</spage><epage>727</epage><pages>723-727</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Background
The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased morbidity and mortality.
Study design
Patients aged 80 and above undergoing inguinal hernia repair were identified from the American College of Surgeons’ National Surgical Quality Improvement Program (2007–2008). Univariate analysis was performed using chi square, Fisher’s exact test and t test. Multivariate logistic regression analysis was carried out to assess factors associated with increased postoperative complications and mortality.
Results
Of 2,377 patients above 80 years of age, 226 (9.5 %) were nonagenarians. Men accounted for 81.4 % (1,936) of patients. There were significantly more female patients in the nonagenarian group (29.2 vs. 17.4 %,
p
< 0.0001). Laparoscopic repair was performed in 210 (9.9 %) patients. Emergency repair was more frequent in nonagenarians than octogenarians (12 vs. 4.4 %,
p
< 0.0001). The 30-day overall complication rate was significantly increased in nonagenarians compared to octogenarians (6.1 vs. 3.2 %,
p
= 0.03). Mortality is increased tenfold in elective inguinal hernia repair in nonagenarians compared to octogenarians (3 vs. 0.3 %,
p
< 0.0005). On multivariate analysis, preoperative variables found to be significantly associated with morbidity included totally dependent functional status, congestive heart failure and emergent nature of procedure, while higher age, emergency repair and open wound are associated with increased mortality.
Conclusions
Elective inguinal hernia repair can be safely performed in octogenarians with low morbidity and mortality but is increased in nonagenarians. More vigilant postoperative care is required after emergent hernia repairs due to the increased risk of morbidity and mortality, and effort should be made to electively repair inguinal hernias early in this elderly population.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>23307025</pmid><doi>10.1007/s10029-012-1040-0</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1265-4906 |
| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2013-12, Vol.17 (6), p.723-727 |
| issn | 1265-4906 1248-9204 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1461345406 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Age Factors Aged, 80 and over Databases, Factual Elective Surgical Procedures - mortality Female Hernia, Inguinal - surgery Herniorrhaphy - methods Herniorrhaphy - mortality Humans Laparoscopy Logistic Models Male Medicine Medicine & Public Health Multivariate Analysis Original Article Postoperative Complications - epidemiology Postoperative Complications - etiology Recurrence Reoperation Risk Factors Treatment Outcome |
| title | Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T23%3A26%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Short-term%20outcomes%20of%20inguinal%20hernia%20repair%20in%20octogenarians%20and%20nonagenarians&rft.jtitle=Hernia%20:%20the%20journal%20of%20hernias%20and%20abdominal%20wall%20surgery&rft.au=Pallati,%20P.%20K.&rft.date=2013-12-01&rft.volume=17&rft.issue=6&rft.spage=723&rft.epage=727&rft.pages=723-727&rft.issn=1265-4906&rft.eissn=1248-9204&rft_id=info:doi/10.1007/s10029-012-1040-0&rft_dat=%3Cproquest_cross%3E3132154811%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1459947191&rft_id=info:pmid/23307025&rfr_iscdi=true |