Risk of death after emergency repair of abdominal wall hernias. Still waiting for improvement

Langenbecks Arch Surg. 2010 Jun;395(5):551-6. doi: 10.1007/s00423-009-0515-7. Epub 2009 Jun 10.


Purpose: The precise importance of factors affecting morbidity and mortality in patients with complicated abdominal wall hernias undergoing emergency surgical repair has been not completely elucidated.

Patients and methods: A retrospective multicentric study of all patients (n = 402) with abdominal wall hernia who underwent urgent operations over 1-year period was conducted in ten hospitals. Logistic regression analysis was used to evaluate variables that affect morbidity and mortality.

Results: Thirty-five percent of patients had inguinal hernia, 22% femoral hernia, 20% umbilical hernia, and 15% incisional hernia. Mesh repair was used in 92.5% of cases. Intestinal resection was required in 49 patients. Perioperative complications occurred in 130 patients, and 18 patients died (mortality rate 4.5%). Complications and mortality rate were significantly higher in the group of intestinal resection. Patients older than 70 years also showed more complications, required intestinal resection more frequently, and had a higher mortality rate than younger patients. In the logistic regression analysis, age over 70 years, intestinal resection, and American Society of Anesthesiologists (ASA) III/IV class emerged as independent predictors of a poor outcome. Based in our results, we propose a simple schema to calculate risk of death in these patients.

Conclusion: Using multivariate logistic regression analysis, probabilities of death after complicated abdominal wall hernia surgery are increased in patients with: age over 70 years, high ASA class, and associated intestinal resection. Guidelines should be developed to improve prognosis in these patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Female
  • Hernia, Abdominal / mortality*
  • Hernia, Abdominal / surgery*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / mortality*
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Statistics, Nonparametric