Follow-up trends after emergency department discharge for acutely symptomatic hernias: A southwestern surgical congress multi-center trial

Am J Surg. 2019 Dec;218(6):1079-1083. doi: 10.1016/j.amjsurg.2019.08.012. Epub 2019 Aug 20.

Abstract

Background: The objective of this multi-center study was to examine the follow-up trends after emergency department (ED) discharge in a large and socioeconomically diverse patient population.

Methods: We performed a 3-year retrospective analysis of adult patients with acutely symptomatic hernias who were discharged from the EDs of five geographically diverse hospitals.

Results: Of 674 patients, 288 (43%) were evaluated in the clinic after discharge from the ED and 253 (37%) underwent repair. Follow-up was highest among those with insurance. A total of 119 patients (18%) returned to the ED for hernia-related complaints, of which 25 (21%) underwent urgent intervention.

Conclusion: The plan of care for patients with acutely symptomatic hernias discharged from the ED depends on outpatient follow-up, but more than 50% of patients are lost to follow-up, and nearly 1 in 5 return to the ED. The uninsured are at particularly high risk.

Keywords: Acute; Emergency department; Follow-up; Insurance status; Surgery; Symptomatic hernia.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Emergency Service, Hospital*
  • Female
  • Follow-Up Studies
  • Herniorrhaphy*
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Male
  • Middle Aged
  • Patient Discharge*
  • Retrospective Studies
  • United States