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Observational Study
. 2024 May 27;409(1):165.
doi: 10.1007/s00423-024-03358-0.

Outpatient Surgery and Unplanned Overnight Admission in Bilateral Inguinal Hernia Repair: A Population-based Study

Nils Jimmy Hidalgo  1 , Salvador Guillaumes  2 , M Magdalena Llompart-Coll  3 , Paula González-Atienza  2 , Irene Bachero  2 , Dulce Momblán  2 , Óscar Vidal  3
Affiliations
Observational Study

Outpatient Surgery and Unplanned Overnight Admission in Bilateral Inguinal Hernia Repair: A Population-based Study

Nils Jimmy Hidalgo et al. Langenbecks Arch Surg. .

Abstract

Purpose: The use of outpatient surgery in inguinal hernia is heterogeneous despite clinical recommendations. This study aimed to analyze the utilization trend of outpatient surgery for bilateral inguinal hernia repair (BHIR) in Spain and identify the factors associated with outpatient surgery choice and unplanned overnight admission.

Methods: A retrospective observational study of patients undergoing BIHR from 2016 to 2021 was conducted. The clinical-administrative database of the Spanish Ministry of Health RAE-CMBD was used. Patient characteristics undergoing outpatient and inpatient surgery were compared. A multivariable logistic regression analysis was performed to identify factors associated with outpatient surgery choice and unplanned overnight admission.

Results: A total of 30,940 RHIBs were performed; 63% were inpatient surgery, and 37% were outpatient surgery. The rate of outpatient surgery increased from 30% in 2016 to 41% in 2021 (p < 0.001). Higher rates of outpatient surgery were observed across hospitals with a higher number of cases per year (p < 0.001). Factors associated with outpatient surgery choice were: age under 65 years (OR: 2.01, 95% CI: 1.92-2.11), hospital volume (OR: 1.59, 95% CI: 1.47-1.72), primary hernia (OR: 1.89, 95% CI: 1.71-2.08), and laparoscopic surgery (OR: 1.47, 95% CI: 1.39-1.56). Comorbidities were negatively associated with outpatient surgery. Open surgery was associated (OR: 1.26, 95% CI: 1.09-1.47) with unplanned overnight admission.

Conclusions: Outpatient surgery for BHIR has increased in recent years but is still low. Older age and comorbidities were associated with lower rates of outpatient surgery. However, the laparoscopic repair was associated with increased outpatient surgery and lower unplanned overnight admission.

Keywords: Bilateral inguinal hernia; Laparoscopic surgery; Outpatient surgery; Unplanned overnight admission.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Case selection flow chart. IHR: Inguinal hernia repair. IDC-10: 10th revision of the international statistical classification of diseases
Fig. 2
Fig. 2
The outpatient surgery rate in bilateral inguinal hernia repair. Cochran-Armitage test for trend was significant (p < 0.001)
Fig. 3
Fig. 3
The outpatient surgery rate of bilateral inguinal hernia repair by hospital volume. Cochran-Armitage test for trend was significant (p < 0.001)
See this image and copyright information in PMC

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