Predictors of early adverse postoperative outcomes following emergency groin hernia surgery: a prospective multicenter cohort

Abstract

Introduction: 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. This study was aimed at determining the predictors of early adverse postoperative outcomes following emergency groin hernia surgery in a low resource setting. Methods: This was a prospective multicenter cohort conducted in the surgical departments of Hoima Regional Referral Hospital (HRRH) and Jinja Regional Referral Hospital (JRRH). All patients who presented with emergency groin hernias during the study period were enrolled. Follow up was done up to discharge. Binary logistic regression in SPSS version 26 was done to determine the predictors. Results: During the study period, 67 patients were enrolled majority of whom were males 56 (83.6%) aged above 45 years 28 (41.8%). Irreducible and obstructed hernias accounted for 20(29.9%) each. Strangulated hernia being the commonest with 27(40.3%) patients, of which 9 were found to have both obstruction and strangulation. Twenty (29.9%) of the participants had complications. The mean length of hospital stay was 5.97 (SD=3.289) days. One (1.5%) patient died. Undergoing gut resection predicted occurrence of early adverse outcomes (AOR=10.250, CI=2.970-35.372, P<0.001). Conclusion 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.