SP3.2.15 Patient demographics and outcomes following emergency presentation with a groin hernia; a 15-year retrospective cohort study from the North of England. (28th October 2021)

• Record Type: Journal Article
• Authors: Clyde, Danielle; Li, Lucy; Swan, Rebecca; McLean, Ross; Brown, Leo
• Is Part Of: British journal of surgery. Volume 108:Supplement 7(2021)
• Publication Date: 2021-10-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab361.079
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aims: Over 70, 000 groin hernia repairs are performed in the UK annually. While most are performed in day-case settings, emergency presentation remains common and has a high associated morbidity and mortality. This study aims to report on patient demographics and outcomes following emergency presentation with a groin hernia. Methods: Data was collected for all patients > 18 years admitted acutely with an inguinal or femoral hernia to NHS trusts between 2002-2016 in the North of England. This included patient demographics and operative interventions. Outcomes of interest were thirty-day inpatient mortality and length of stay (LoS). Results: Overall, 6165 patients presented as an emergency with a groin hernia (76.2% inguinal) over the 15-year study period. There was a male preponderance (n = 4469, 72.5%) with a median age of 73 years (IQR: 58, 82). No changes in the distribution of age or gender were noted over the study period. Comorbidity, as measured by Charlson score, increased over time (p < 0.001). Median LoS was 2 days (IQR: 1, 5), increasing with age and comorbidity (both p < 0.001). Emergency surgery was performed for 3904 patients (63.3%). The thirty-day mortality rate of 3.1% rose to 3.7% in the subgroup of patients undergoing operative repair and 5.6% in those with associated bowel obstruction. Greater comorbidity and advanced age were again associated with increased mortality (both p < 0.001). Conclusions: This study highlights changing patient demographics more comorbid patients presenting acutely with groin hernias. These patients must be counselled regarding their increased mortality risk as part of the shared decision-making process.