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Racial Disparities in Emergent Versus Elective Inguinal Hernia Repair.

Jayati Atahar¹, Jacob Zarkower¹, Hari Ramesh¹

¹Department of Surgery, The George Washington University School of Medicine and Health Services, Washington, DC.

The Journal of Surgical Research

|June 24, 2026

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Black patients are nearly twice as likely to need emergency inguinal hernia repair (IHR). While emergency IHR increases mortality risk, outcomes for Black patients are similar to White patients, though disparities exist across racial groups.

Area of Science:

Surgical Outcomes Research
Health Disparities
Racial Equity in Healthcare

Background:

Racial disparities significantly impact surgical outcomes, particularly for conditions like inguinal hernias where delayed care can lead to emergency procedures.
Elective inguinal hernia repair (IHR) is associated with better patient outcomes than emergent IHR.
Understanding racial variations in IHR outcomes is crucial for addressing healthcare inequities.

Purpose of the Study:

To investigate the association between race and the likelihood of undergoing emergency versus elective inguinal hernia repair (IHR).
To compare 30-day postoperative outcomes following IHR across different racial groups.
To identify potential racial disparities in surgical repair urgency and outcomes.

Main Methods:

Keywords:

Inguinal hernia Racial disparities Racial-based outcomes

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Analysis of adult patients who underwent IHR, utilizing logistic and binomial regression models.
Primary outcome: odds of emergency vs. elective surgical repair by race.
Secondary outcomes: 30-day postoperative results, adjusted for demographics and comorbidities.

Main Results:

Emergency repairs were more frequent in Black patients (OR 1.75, P < 0.01).
Emergency repair significantly increased 30-day mortality risk (OR 8.29, P < 0.01) compared to elective repair.
American Indian/Alaska Native patients faced higher odds of return to operating room (OR 3.19) and surgical site infections (OR 2.50) within the emergency cohort.

Conclusions:

Black patients exhibit a higher likelihood of emergent IHR but demonstrate comparable outcomes to White patients.
Significant differences in outcomes exist between emergency and elective IHR, varying by race.
Addressing racial disparities in the timing and outcomes of inguinal hernia repair is essential.