Patterns and factors associated with early adverse postoperative outcomes  among emergency groin hernia patients; a multicenter study

Mumin Farah Ismail

Patterns and factors associated with early adverse postoperative outcomes among emergency groin hernia patients; a multicenter study

Date

2023-03

Authors

Mumin Farah Ismail

Publisher

Kampala International University

Abstract

Groin hernias accounts for 70% of all abdominal hernias and up to 40% of the groin hernia operations are done as emergencies. The percentage of groin hernias operated as emergencies is even higher in low- and middle-income countries like Uganda. Emergency hernia Surgeries have been associated with a higher risk of adverse outcomes. There is paucity of data on the patterns of presentation and factors associated with outcomes of emergency groin hernia surgery in Uganda; the reason this study was done. Methods This was a longitudinal observational study conducted in the surgical departments of Hoima Regional Referral Hospital (HRRH) and Jinja Regional Referral Hospital (JRRH). All patients who came with complicated or emergency groin hernia during the period of the study were enrolled if they consented. Follow up was done from admission up to discharge of the patient and adverse outcomes documented. Analysis was done using SPSS version 26. Results During the study period, 67 patients were enrolled. Most of the participants were males 56(83.6%) aged above 45 years 28(41.8%). Irreducible and obstructed hernias accounted for 20(29.9%) each. Eighteen (26.9%) had strangulation alone while 9(13.4%) had both strangulation and obstruction. Twenty (29.9%) of the participants had complications. The commonest complication was surgical site infection 8(11.9%), six cases from strangulated and two cases of obstructed hernias. The mean length of hospital stay was 5.97 (SD=3.289) days. One (1.5%) patient died. The only factor that was independently associated with adverse outcome was gut resection (AOR=10.250, CI=2.970 35.372, P<0.001). Conclusion The commonest patterns were strangulation and obstruction. The rate of adverse outcomes was high at 29.9%, though the mortality was low. The only factor that independently predicted adverse outcome was gut resection. More attention is still needed to reduce the rate of adverse outcomes following emergency hernia surgery with a lot of focus on surgical site infection and patients undergoing gut resection.