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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
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Recurrent emergent hernia repairs: who is at risk?
Erin E Isenberg1,2, Joshua Sinamo3, Michael A Rubyan4
1Department of Surgery, University of Texas at Southwestern, Dallas, TX, USA. isenbere@med.umich.edu.
Surgical Endoscopy
|June 19, 2025
Summary
Female, Hispanic, and socially vulnerable patients face higher risks of recurrent emergent hernia repairs. Interventions should consider repair approach and targeted follow-up for high-risk populations.
Area of Science:
- General Surgery
- Health Services Research
- Epidemiology
Background:
- Recurrent emergent hernia repairs involve vulnerable patient populations.
- Characterizing these patients is crucial for identifying intervention opportunities.
Purpose of the Study:
- To characterize Medicare beneficiaries undergoing recurrent emergent hernia repairs.
- To identify patient, provider, and community factors associated with increased risk.
Main Methods:
- Retrospective cross-sectional study of Medicare beneficiaries (2011-2021).
- Multivariable risk-adjusted survival analysis for cumulative recurrent emergent hernia repair incidence within 10 years.
- Utilized the CDC's Social Vulnerability Index to measure social risk.
Main Results:
- Among 120,227 patients, 10-year cumulative incidence of recurrent emergent hernia repair was 6.4%.
- Increased risk associated with female sex, Hispanic ethnicity, and highest social vulnerability quintile.
- Open repair approach and for-profit hospitals also showed increased risk.
Conclusions:
- Female, Hispanic, and socially vulnerable patients are at higher risk for recurrent emergent hernia repairs.
- Open index repair and care at for-profit hospitals are associated with increased recurrence risk.
- Highlights need for targeted interventions, closer follow-up, and consideration of index repair approach.
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