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Emergency hernia repairs in elderly patients
José A Alvarez Pérez1, Ricardo F Baldonedo, Isabel G Bear
1Department of General Surgery, Hospital San Agustin, Avilés, Spain. josealvar@telecable.es
International Surgery
|January 14, 2004
Summary
Emergency hernia repair in elderly patients carries significant risks. Delayed treatment, comorbidities, and high anesthesia scores increase complications and mortality, highlighting the need for early elective surgery.
Area of Science:
- Geriatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- Elderly patients face increased risks during emergency surgical repairs.
- Incarcerated external hernias present unique challenges in this demographic.
- Understanding factors influencing outcomes is crucial for optimizing care.
Purpose of the Study:
- To determine the clinical presentation, morbidity, and mortality associated with emergency hernia repair in patients over 65.
- To identify factors impacting the outcome of emergency surgical repair in the elderly.
Main Methods:
- Retrospective study of 143 patients (age > 65) undergoing emergency surgical repair for incarcerated external hernias (1992-2001).
- Analysis of patient demographics, symptom onset, coexisting conditions, surgical procedures, and postoperative outcomes.
- Statistical evaluation of factors associated with unfavorable outcomes.
Main Results:
- 35% of patients presented after 48 hours; 77.7% had coexisting diseases.
- Bowel resection was necessary in 17.5% of cases.
- Overall morbidity was 46.2%, with major complications in 11.9%; mortality rate was 4.9%.
Conclusions:
- Longer symptom duration, delayed hospitalization, comorbidities, and high American Society of Anesthesiologists scores are linked to poor outcomes.
- Early elective surgery and priority admission are recommended to mitigate risks in elderly patients undergoing hernia repair.