Risk Factors for Incarceration in Groin Hernias: Prospective Observational Study
Overview
This prospective study of 654 groin hernia patients identified key risk factors associated with incarceration requiring emergency surgery. Female gender, higher ASA scores, diabetes mellitus, cardiovascular disease, and prior abdominal surgery were significantly linked to increased risk of hernia incarceration.
Background
Groin hernias are common benign conditions often requiring surgical repair. Incarceration or strangulation of hernias leads to serious morbidity and necessitates urgent intervention. Identifying risk factors for incarceration can guide clinical decision-making and prioritize elective surgery, especially in settings with long surgical wait times. This study prospectively analyzed patients undergoing elective or emergency hernia repair to determine factors associated with incarceration.
Data Highlights
Characteristic
Elective Surgery (n=519)
Emergency Surgery (n=135)
Significance
Female Gender
9.5%
Higher risk (OR 3.20, 95% CI: 1.85–5.52)
p < 0.05
ASA Score III
Lower
Higher (OR 4.876, 95% CI: 2.06–11.52)
p = 0.001
Diabetes Mellitus
Lower
Higher (OR 1.696, 95% CI: 1.03–2.80)
p = 0.037
Cardiovascular Disease
Lower
Higher (OR 1.802, 95% CI: 1.183–2.75)
p < 0.05
History of Abdominal Surgery
Lower
Higher (OR 1.546, 95% CI: 1.05–2.67)
p = 0.025
History of Gastrointestinal Surgery
Lower
Higher (OR 1.584, 95% CI: 1.04–2.42)
p = 0.033
Key Findings
Female patients had a significantly higher risk of emergency surgery for incarcerated hernia (OR 3.20).
Higher ASA physical status scores, especially ASA III, were strongly associated with incarceration risk.
Diabetes mellitus increased the odds of emergency surgery due to incarceration.
Cardiovascular disease was significantly linked to higher incarceration risk.
Patients with a history of abdominal or gastrointestinal surgery had increased risk of emergency hernia repair.
Age and BMI were not significantly associated with incarceration risk.
Clinical Implications
Clinicians should consider female gender, comorbidities such as diabetes and cardiovascular disease, and prior abdominal surgeries as important risk factors for hernia incarceration. These factors may warrant closer monitoring and prioritization for elective repair to prevent emergency presentations. ASA score can be a useful tool to stratify risk in patients with groin hernias.
Conclusion
This study identifies multiple patient-related factors that increase the risk of groin hernia incarceration necessitating emergency surgery. Recognizing these risk factors can improve patient management and surgical prioritization.
References
Bakirköy Dr. Sadi Konuk Training and Research Hospital Study 2021-2023 -- Identifying Risk Factors for Incarceration in Groin Hernias
