Delay in emergency hernia surgery is associated with worse outcomes
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and Other Interventional Techniques
Delay in emergency hernia surgery is associated with worse outcomes Ira L. Leeds1 · Christian Jones1 · Sandra R. DiBrito1 · Joseph V. Sakran1 · Elliott R. Haut1,2,3 · Alistair J. Kent1 Received: 20 May 2019 / Accepted: 28 October 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Patients requiring emergent surgery for hernia vary widely in presentation and management. The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. Methods The national NSQIP database for years 2011–2016 was queried for emergent surgeries for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Diaphragmatic hernias were excluded. Patients were grouped by surgical timing from admission to day of surgery: same day, next day, and longer delay. Multinomial propensity score weighting was used to address potential differences in underlying covariates’ clustering across the timing groups followed by multivariable logistic regression of morbidity and mortality. Results Weighted analysis yielded an effective sample size of 76,364. Hernia types included inguinal (20.9%); femoral (6.7%); umbilical (20.2%); ventral (41.0%); and other (10.4%). Delayed surgery was associated with increased rates of major complications (26.4% vs. 20.9%, p
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