Abi-Haidar et al identified risk factors for acute vs elective groin hernia surgery. Because the complications of acute hernia repair are higher, identifying patients at risk can help to identify a patient who may benefit from a planned procedure. The authors are from the VA Boston Healthcare System, Boston University and Harvard Medical School.


Acute groin surgery appears to incorporate both urgent and emergent surgeries.


Risk factors for an acute operation for a groin hernia:

(1) older age (increases after 50 with greatest risk after 65 years of age)

(2) femoral or scrotal hernia

(3) recurrent hernia

(4) indirect hernia


A bilateral hernia tends to undergo an elective repair.


Risk factors for increased morbidity and mortality in a patient undergoing acute surgery:

(1) comorbid conditions including coagulopathy

(2) delay in diagnosis

(3) incarcerated hernia

(4) infection


The authors concluded that a patient with multiple risk factors should be evaluated for elective surgery even if the hernia has minimal symptoms or if the patient has comorbid conditions.


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