Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data

In pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. The Nationwide Readmissions Database was used to identify pediatric patients (aged < 18 y) with incarcerated inguinal hernia from 20...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of surgical research 2024-03, Vol.295, p.641-646
Main Authors: Ramsey, Walter A., Huerta, Carlos T., O’Neil, Christopher F., Taylor, Ruby R., Saberi, Rebecca A., Gilna, Gareth P., Collie, Brianna L., Lyons, Nicole B., Parreco, Joshua P., Thorson, Chad M., Sola, Juan E., Perez, Eduardo A.
Format: Article
Language:English
Subjects:
Incarcerated inguinal hernia
Inguinal hernia repair
Pediatric inguinal hernia
Readmission
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613
cites cdi_FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613
container_end_page 646
container_issue
container_start_page 641
container_title The Journal of surgical research
container_volume 295
creator Ramsey, Walter A.
Huerta, Carlos T.
O’Neil, Christopher F.
Taylor, Ruby R.
Saberi, Rebecca A.
Gilna, Gareth P.
Collie, Brianna L.
Lyons, Nicole B.
Parreco, Joshua P.
Thorson, Chad M.
Sola, Juan E.
Perez, Eduardo A.
description In pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. The Nationwide Readmissions Database was used to identify pediatric patients (aged < 18 y) with incarcerated inguinal hernia from 2010 to 2014. Patients were stratified by management approach (Early Repair versus Deferral). Overall frequencies of these operative strategies were calculated. Propensity score matching was then performed to control for patient age, comorbidities, perinatal conditions, and congenital anomalies. Outcomes including complications, surgical procedures, and readmissions were compared. Outpatient surgeries were not assessed. Among 6148 total patients with incarcerated inguinal hernia, the most common strategy was to perform Early Repair (88% versus 12% Deferral). Following propensity score matching, the cohort included 1288 patients (86% male, average age 1.7 ± 4.1 years). Deferral was associated with equivalent rates of readmission within one year (13% versus 15%, P = 0.143), but higher readmissions within the first 30 days (7% versus 3%, P = 0.002) than Early Repair. Deferral patients had lower rates of orchiectomy (2% versus 5%, P = 0.001), wound infections (< 2% versus 2%, P = 0.020), and other infections (7% versus 15%, P 
doi_str_mv 10.1016/j.jss.2023.11.059
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2903327886</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022480423006315</els_id><sourcerecordid>2903327886</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613</originalsourceid><addsrcrecordid>eNp9kEtPwzAQhC0EoqXwA7igHLkk-NE4Dpyq8milChAqZ8ux15WrNil2QsW_x1GBI6fdsWZG3g-hS4Izggm_WWfrEDKKKcsIyXBeHqEhwWWeCl6wYzTEmNJ0LPB4gM5CWOOoy4KdogETBDNGyRCppdu6epU0NnkF41TrnU7mtVZeg1ctmChWnavVJpmBr51K3mCnnL9NJnH7dLDvo8-qdU29dwbiozJbF0LUIblXrTpHJ1ZtAlz8zBF6f3xYTmfp4uVpPp0sUs1y1qa2EroCU1LAldaFFgYLYa2xhTC81JybnENJuBpbQqHixFZWiOhRvKSWEzZC14fenW8-OgitjN_QsNmoGpouSFr2JxdC8GglB6v2TQgerNx5t1X-SxIse7JyLSNZ2ZOVhMhINmaufuq7agvmL_GLMhruDgaIR0YwXgbtoNaRqgfdStO4f-q_Af8Digk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2903327886</pqid></control><display><type>article</type><title>Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data</title><source>ScienceDirect Journals</source><creator>Ramsey, Walter A. ; Huerta, Carlos T. ; O’Neil, Christopher F. ; Taylor, Ruby R. ; Saberi, Rebecca A. ; Gilna, Gareth P. ; Collie, Brianna L. ; Lyons, Nicole B. ; Parreco, Joshua P. ; Thorson, Chad M. ; Sola, Juan E. ; Perez, Eduardo A.</creator><creatorcontrib>Ramsey, Walter A. ; Huerta, Carlos T. ; O’Neil, Christopher F. ; Taylor, Ruby R. ; Saberi, Rebecca A. ; Gilna, Gareth P. ; Collie, Brianna L. ; Lyons, Nicole B. ; Parreco, Joshua P. ; Thorson, Chad M. ; Sola, Juan E. ; Perez, Eduardo A.</creatorcontrib><description>In pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. The Nationwide Readmissions Database was used to identify pediatric patients (aged &lt; 18 y) with incarcerated inguinal hernia from 2010 to 2014. Patients were stratified by management approach (Early Repair versus Deferral). Overall frequencies of these operative strategies were calculated. Propensity score matching was then performed to control for patient age, comorbidities, perinatal conditions, and congenital anomalies. Outcomes including complications, surgical procedures, and readmissions were compared. Outpatient surgeries were not assessed. Among 6148 total patients with incarcerated inguinal hernia, the most common strategy was to perform Early Repair (88% versus 12% Deferral). Following propensity score matching, the cohort included 1288 patients (86% male, average age 1.7 ± 4.1 years). Deferral was associated with equivalent rates of readmission within one year (13% versus 15%, P = 0.143), but higher readmissions within the first 30 days (7% versus 3%, P = 0.002) than Early Repair. Deferral patients had lower rates of orchiectomy (2% versus 5%, P = 0.001), wound infections (&lt; 2% versus 2%, P = 0.020), and other infections (7% versus 15%, P &lt; 0.001). The frequency of other complications including bowel resection, oophorectomy, testicular atrophy, sepsis, and pneumonia were equivalent between groups. Three percent of Deferrals had a diagnosis of incarceration on readmission. Deferral of incarcerated inguinal hernia repair at index admission is associated with higher rates of hospital readmissions within the first 30 days but equivalent readmission within the entire calendar year. These patients are at risk of repeat incarceration but have significantly lower rates of orchiectomy than their counterparts who undergo inguinal hernia repair at the index admission. We propose that prospective studies be performed to identify good candidates for Elective Deferral following manual reduction and overnight observation. Such studies must capture outpatient surgical outcomes.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2023.11.059</identifier><identifier>PMID: 38103321</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Incarcerated inguinal hernia ; Inguinal hernia repair ; Pediatric inguinal hernia ; Readmission</subject><ispartof>The Journal of surgical research, 2024-03, Vol.295, p.641-646</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613</citedby><cites>FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613</cites><orcidid>0000-0002-1459-0342</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38103321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramsey, Walter A.</creatorcontrib><creatorcontrib>Huerta, Carlos T.</creatorcontrib><creatorcontrib>O’Neil, Christopher F.</creatorcontrib><creatorcontrib>Taylor, Ruby R.</creatorcontrib><creatorcontrib>Saberi, Rebecca A.</creatorcontrib><creatorcontrib>Gilna, Gareth P.</creatorcontrib><creatorcontrib>Collie, Brianna L.</creatorcontrib><creatorcontrib>Lyons, Nicole B.</creatorcontrib><creatorcontrib>Parreco, Joshua P.</creatorcontrib><creatorcontrib>Thorson, Chad M.</creatorcontrib><creatorcontrib>Sola, Juan E.</creatorcontrib><creatorcontrib>Perez, Eduardo A.</creatorcontrib><title>Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>In pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. The Nationwide Readmissions Database was used to identify pediatric patients (aged &lt; 18 y) with incarcerated inguinal hernia from 2010 to 2014. Patients were stratified by management approach (Early Repair versus Deferral). Overall frequencies of these operative strategies were calculated. Propensity score matching was then performed to control for patient age, comorbidities, perinatal conditions, and congenital anomalies. Outcomes including complications, surgical procedures, and readmissions were compared. Outpatient surgeries were not assessed. Among 6148 total patients with incarcerated inguinal hernia, the most common strategy was to perform Early Repair (88% versus 12% Deferral). Following propensity score matching, the cohort included 1288 patients (86% male, average age 1.7 ± 4.1 years). Deferral was associated with equivalent rates of readmission within one year (13% versus 15%, P = 0.143), but higher readmissions within the first 30 days (7% versus 3%, P = 0.002) than Early Repair. Deferral patients had lower rates of orchiectomy (2% versus 5%, P = 0.001), wound infections (&lt; 2% versus 2%, P = 0.020), and other infections (7% versus 15%, P &lt; 0.001). The frequency of other complications including bowel resection, oophorectomy, testicular atrophy, sepsis, and pneumonia were equivalent between groups. Three percent of Deferrals had a diagnosis of incarceration on readmission. Deferral of incarcerated inguinal hernia repair at index admission is associated with higher rates of hospital readmissions within the first 30 days but equivalent readmission within the entire calendar year. These patients are at risk of repeat incarceration but have significantly lower rates of orchiectomy than their counterparts who undergo inguinal hernia repair at the index admission. We propose that prospective studies be performed to identify good candidates for Elective Deferral following manual reduction and overnight observation. Such studies must capture outpatient surgical outcomes.</description><subject>Incarcerated inguinal hernia</subject><subject>Inguinal hernia repair</subject><subject>Pediatric inguinal hernia</subject><subject>Readmission</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPwzAQhC0EoqXwA7igHLkk-NE4Dpyq8milChAqZ8ux15WrNil2QsW_x1GBI6fdsWZG3g-hS4Izggm_WWfrEDKKKcsIyXBeHqEhwWWeCl6wYzTEmNJ0LPB4gM5CWOOoy4KdogETBDNGyRCppdu6epU0NnkF41TrnU7mtVZeg1ctmChWnavVJpmBr51K3mCnnL9NJnH7dLDvo8-qdU29dwbiozJbF0LUIblXrTpHJ1ZtAlz8zBF6f3xYTmfp4uVpPp0sUs1y1qa2EroCU1LAldaFFgYLYa2xhTC81JybnENJuBpbQqHixFZWiOhRvKSWEzZC14fenW8-OgitjN_QsNmoGpouSFr2JxdC8GglB6v2TQgerNx5t1X-SxIse7JyLSNZ2ZOVhMhINmaufuq7agvmL_GLMhruDgaIR0YwXgbtoNaRqgfdStO4f-q_Af8Digk</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Ramsey, Walter A.</creator><creator>Huerta, Carlos T.</creator><creator>O’Neil, Christopher F.</creator><creator>Taylor, Ruby R.</creator><creator>Saberi, Rebecca A.</creator><creator>Gilna, Gareth P.</creator><creator>Collie, Brianna L.</creator><creator>Lyons, Nicole B.</creator><creator>Parreco, Joshua P.</creator><creator>Thorson, Chad M.</creator><creator>Sola, Juan E.</creator><creator>Perez, Eduardo A.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1459-0342</orcidid></search><sort><creationdate>20240301</creationdate><title>Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data</title><author>Ramsey, Walter A. ; Huerta, Carlos T. ; O’Neil, Christopher F. ; Taylor, Ruby R. ; Saberi, Rebecca A. ; Gilna, Gareth P. ; Collie, Brianna L. ; Lyons, Nicole B. ; Parreco, Joshua P. ; Thorson, Chad M. ; Sola, Juan E. ; Perez, Eduardo A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Incarcerated inguinal hernia</topic><topic>Inguinal hernia repair</topic><topic>Pediatric inguinal hernia</topic><topic>Readmission</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramsey, Walter A.</creatorcontrib><creatorcontrib>Huerta, Carlos T.</creatorcontrib><creatorcontrib>O’Neil, Christopher F.</creatorcontrib><creatorcontrib>Taylor, Ruby R.</creatorcontrib><creatorcontrib>Saberi, Rebecca A.</creatorcontrib><creatorcontrib>Gilna, Gareth P.</creatorcontrib><creatorcontrib>Collie, Brianna L.</creatorcontrib><creatorcontrib>Lyons, Nicole B.</creatorcontrib><creatorcontrib>Parreco, Joshua P.</creatorcontrib><creatorcontrib>Thorson, Chad M.</creatorcontrib><creatorcontrib>Sola, Juan E.</creatorcontrib><creatorcontrib>Perez, Eduardo A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramsey, Walter A.</au><au>Huerta, Carlos T.</au><au>O’Neil, Christopher F.</au><au>Taylor, Ruby R.</au><au>Saberi, Rebecca A.</au><au>Gilna, Gareth P.</au><au>Collie, Brianna L.</au><au>Lyons, Nicole B.</au><au>Parreco, Joshua P.</au><au>Thorson, Chad M.</au><au>Sola, Juan E.</au><au>Perez, Eduardo A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>295</volume><spage>641</spage><epage>646</epage><pages>641-646</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>In pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. The Nationwide Readmissions Database was used to identify pediatric patients (aged &lt; 18 y) with incarcerated inguinal hernia from 2010 to 2014. Patients were stratified by management approach (Early Repair versus Deferral). Overall frequencies of these operative strategies were calculated. Propensity score matching was then performed to control for patient age, comorbidities, perinatal conditions, and congenital anomalies. Outcomes including complications, surgical procedures, and readmissions were compared. Outpatient surgeries were not assessed. Among 6148 total patients with incarcerated inguinal hernia, the most common strategy was to perform Early Repair (88% versus 12% Deferral). Following propensity score matching, the cohort included 1288 patients (86% male, average age 1.7 ± 4.1 years). Deferral was associated with equivalent rates of readmission within one year (13% versus 15%, P = 0.143), but higher readmissions within the first 30 days (7% versus 3%, P = 0.002) than Early Repair. Deferral patients had lower rates of orchiectomy (2% versus 5%, P = 0.001), wound infections (&lt; 2% versus 2%, P = 0.020), and other infections (7% versus 15%, P &lt; 0.001). The frequency of other complications including bowel resection, oophorectomy, testicular atrophy, sepsis, and pneumonia were equivalent between groups. Three percent of Deferrals had a diagnosis of incarceration on readmission. Deferral of incarcerated inguinal hernia repair at index admission is associated with higher rates of hospital readmissions within the first 30 days but equivalent readmission within the entire calendar year. These patients are at risk of repeat incarceration but have significantly lower rates of orchiectomy than their counterparts who undergo inguinal hernia repair at the index admission. We propose that prospective studies be performed to identify good candidates for Elective Deferral following manual reduction and overnight observation. Such studies must capture outpatient surgical outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38103321</pmid><doi>10.1016/j.jss.2023.11.059</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1459-0342</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0022-4804
ispartof The Journal of surgical research, 2024-03, Vol.295, p.641-646
issn 0022-4804
1095-8673
language eng
recordid cdi_proquest_miscellaneous_2903327886
source ScienceDirect Journals
subjects Incarcerated inguinal hernia
Inguinal hernia repair
Pediatric inguinal hernia
Readmission
title Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T19%3A17%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Timing%20of%20Pediatric%20Incarcerated%20Inguinal%20Hernia%20Repair:%20A%20Review%20of%20Nationwide%20Readmissions%20Data&rft.jtitle=The%20Journal%20of%20surgical%20research&rft.au=Ramsey,%20Walter%20A.&rft.date=2024-03-01&rft.volume=295&rft.spage=641&rft.epage=646&rft.pages=641-646&rft.issn=0022-4804&rft.eissn=1095-8673&rft_id=info:doi/10.1016/j.jss.2023.11.059&rft_dat=%3Cproquest_cross%3E2903327886%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c353t-fb8cbed92e0bcc7c8d088ffdf78d69c66d56e916a4f12eb61fbf88088a692f613%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2903327886&rft_id=info:pmid/38103321&rfr_iscdi=true