Risk factors for bowel resection and outcome in patients with incarcerated groin hernias

Abstract

Purpose: This retrospective study aimed to evaluate the risk factors for bowel resection and outcome in patients with incarcerated groin hernias.

Methods: The records of all adult patients who had undergone emergency hernia repair for incarcerated groin hernia from January 1999 to June 2009 were analyzed. One hundred and eighty-two patients with incarcerated groin hernias were included in this study. Bowel resection was required in 28 patients (15.4%).

Results: One hundred and twenty-six patients (69.2%) were covered by various types of health insurance. Twenty-six patients (14.3%) were hospitalized for mechanical bowel obstruction or had obvious symptoms of simultaneous bowel obstruction. Obvious peritonitis was found in seven patients (3.8%). A logistic regression model identified three independent risk factors for bowel resection: lack of health insurance (odds ratio [OR], 5, P = 0.005), obvious peritonitis (OR, 11.52, P = 0.019), and femoral hernia (OR, 8.31, P < 0.001). Postoperative complications (standardized coefficient [SC] = 0.478, P < 0.001), presentation of bowel obstruction on admission (SC = 0.169, P = 0.017), and having health insurance (SC = 0.153, P = 0.030) were associated with prolonged length of stay. No factors were found to be directly associated with morbidity or mortality.

Conclusions: Risk for intestinal resection in emergency groin hernia repair is higher in patients with femoral hernia, obvious peritonitis, or those with no health insurance. Surgeons should pay more attention to these patients and initiate emergency surgery without delay.