Elderly men most likely to need emergency hernia repair

By David Douglas

NEW YORK (Reuters Health) - Emergency hernia repair rates are increasing in the U.S., particularly in men older than 65, a new study shows.

"The significance of this study is that it pinpoints the drivers of emergent hernia surgery in the U.S. and the predominant subset of the population affected, namely incisional ventral hernias in older men," Dr. Anthony G. Charles, of the University of North Carolina School of Medicine, Chapel Hill, told Reuters Health by email.

Dr. Charles and colleagues note that emergency repair is associated with increased morbidity, length of stay, and mortality.

As reported January 7 online in JAMA Surgery, the researchers reviewed nationally representative data on inpatient hospitalizations for hernia repair between 2001 and 2010. They estimated that of 2.3 million abdominal hernia repairs, 567,000 were emergency procedures.

Over the study period, emergency repair rates rose from 16.0 to 19.2 per 100,000 person-years. The rates were highest in people older than 65, at 71.3 per 100,000 person years in men and 42.0 per 100,000 person years in women.

In particular, rates of emergency incisional hernia repair were high but relatively stable in older women, at 24.9 per 100,000 person-years in 2001 and 23.5 per 100,000 person-years in 2010. However, corresponding rates in older men rose significantly, from 7.8 to 32.0 per 100,000 person-years.

These increasing rates, say the investigators, are troublesome because of the significantly increased risk of morbidity and mortality associated with such repair.

Because this is the fastest growing segment of the U.S. population, they conclude, "efforts to increase access to primary and surgical care are imperative to ameliorate the associated sequelae."

The authors report no external funding or conflicts of interest.

SOURCE: http://bit.ly/1wcpDu4

JAMA Surg 2014.

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