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Related Experiment Videos

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
PubMed
Summary
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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.

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  • 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.