Hernias of the abdominal wall in patients over the age of 70 years

Authors

  • Juan J. Arenal,

  • Paloma Rodríguez-Vielba,

  • Emiliano Gallo,

  • Claudia Tinoco


Abstract

Objective:

To find out if the patients' age affects the treatment of abdominal hernias and the results in relation of the age increase.

Design:

Retrospective and prospective study.

Setting:

University hospital, Spain.

Subjects:

664 patients aged 70 years or more operated on for abdominal hernia between 1986–1998. Patients were divided into three groups: 443 aged 70–79; 202 aged 80–89; and 19 patients aged 90 years or more.

Main outcome measures:

Perioperative risk, type of surgery and deaths.

Results:

117 women (52%) had femoral hernias, compared with 32 men (7%) (p = 0.0001). The incidence of femoral hernia over 80 years of age was 79/221 (36%) compared with 70/443 (16%) among patients in their seventies (p = 0.0001). 97 of the patients aged 70–79 (22%) were operated on as emergencies, 107 of those aged 80–89 (53%), and 17 in patients 90 or older (89%, p = 0.0001). The mortality rate was 1% in the 70–79 group (n = 6), 5% (n = 10) in the 80–89 group, and 3/19 died in the over 90 group (p = 0.0001). No deaths were reported after elective surgery.

Conclusion:

Emergency operations in elderly patients with abdominal wall hernias are increasingly more common as the patient get older. As result, there is an unacceptable increase in postoperative mortality.

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