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© 1996 Oxford University Press

research-article

Inguinal Hernia Repair: Incidence of Elective and Emergency Surgery, Readmission and Mortality

PAOLA PRIMATESTA and MICHAEL J GOLDACRE

Unit of Health-Care Epidemiology, Department of Public Health and Primary Care, University of Oxford Oxford OX3 7LF, UK.

BACKGROUND: Inguinal hemia repair is one of the most common operations undertaken in routine surgical practice. It generally carries a very low risk of major adverse sequelae. We analysed profiles, separately, for elective and emergency operations to report on the incidence and major adverse outcomes of inguinal hemia repair in a geographically defined population.

METHODS: Age- and sex-specific hospital admission rates, emergency readmission rates within 30 days of discharge, and mortality rates, separately for elective and emergency operations, were calculated for the penod 1976–1986 in the Oxford Record Linkage Study (ORLS) area.

RESULTS: In all, 30 675 Inguinal hemia repairs were performed in the area, an all-ages annual incidence of 13 per 10 000 population. Some 9% of patients underwent operation in an emergency admission. Elective operation rates remained constant over time. Emergency repairs decreased significantly over time in males. Patients who underwent emergency repair were older, had higher emergency readmission rates than those undergoing elective repair, and had significantly elevated postoperative mortality rates. In those who died it was uncommon for inguinal hemia to be recorded on their death certificates. Of the operations, 91% were undertaken on males; age-specific rates were highest in infants and the elderly; and emergency operation rates rose exponentially with age in people >50 years.

CONCLUSIONS: The lifetime ‘risk’ of inguinal hemia repair is high: at currently prevailing rates we estimate it at 27%for men and 3% for women. There Is significant elevation of mortality after emergency operations. Elective repair of Inguinal hemia should be undertaken soon after the diagnosis is made to minimize the risk of adverse outcomes.

Keywords Inguinal hemia repair, inguinal hemia epidemiology, postoperative mortality, postoperative morbidity, avoidable deaths, lifetime risk

Revised 1 November 1995


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