Evidence map›Paper›PMID 27438793›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2017

Should we perform elective inguinal hernia repair in the elderly?

J J Wu, B C Baldwin, E Goldwater, T C Counihan

Abstract read
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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Emergency hernia hospitalizations in older adults with and without multimorbidity.Hernia : the journal of hernias and abdominal wall surgery · 2026
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  7. Observational
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  11. Impact of nonmalignant ascites on outcomes of open inguinal hernia repair in the USA.Hernia : the journal of hernias and abdominal wall surgery · 2023
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  12. Observational
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  16. Surgical trends of groin hernia repairs performed for recurrence in medicare patients.Hernia : the journal of hernias and abdominal wall surgery · 2019
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  18. Comment to: Should we perform elective inguinal hernia repair in the elderly? Wu J. J. et al.Hernia : the journal of hernias and abdominal wall surgery · 2017
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 1 country.

J J WuBaystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA. Jacqueline.wumd@baystatehealth.org.ORCID 0000-0002-9208-0882
B C BaldwinBerkshire Medical Center, 725 North Street, Pittsfield, MA, 01201, USA.
E GoldwaterUniversity of Massachusetts Amherst, Amherst, MA, USA.
T C CounihanVeteran Affairs Medical Center, White River Junction, VT, USA.
Baystate Medical Center · USBerkshire Medical Center · USUniversity of Massachusetts Amherst · USWhite River Junction VA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany surgeons are reluctant to offer elective inguinal and femoral hernia repair (IHR) to the elderly due to concerns of increased risk. The authors sought to evaluate the outcomes of elderly patients undergoing IHR compared to the general population.

methodsWe performed a retrospective review of the 2011 NSQIP database evaluating 19,683 patients undergoing IHR. Patients were divided by age into three categories: <65, 65-79 and >80. Logistic regression analysis was used to assess impact of comorbid conditions and type of surgery on outcomes. Patients were analyzed for mortality and complications based on their age and the types of surgery (elective, urgent, emergent, laparoscopic versus open) and comorbid conditions.

resultsThere were 17,375 male patients (88 %). 92.7 % were elective. 70 % were performed using an open technique. Age distribution was 63.4 % < 65, 26.6 % 65-79, 10 % >80. Mortality was similar across age groups in elective repair. Mortality was increased in emergency repair in all age groups (p < 0.001). Mortality was increased in emergency surgery compared to elective surgery in patients >80 (OR = 57, p < 0.001). Mortality was similar between laparoscopic and open in <65 (OR = 0.96, p = 0.97) and unable to be assessed in other age groups. Dyspnea and COPD predicted higher mortality and complications with emergency surgery in the elderly (age 65-79 OR 15.3 and 14.9, respectively, age >80 OR 56.5 and 14.9, respectively).

conclusionsElective inguinal hernia repair carries a similar mortality in the elderly compared to the general population. Emergent IHR carries a very high risk of death in the elderly. The authors recommend considering elective IHR regardless of age.

Indexed as

AgedAged, 80 and overAge FactorsDatabases, FactualElective Surgical ProceduresFemaleHernia, InguinalHerniorrhaphyHumansMaleMiddle AgedRetrospective StudiesRisk FactorsUnited StatesElderlyInguinal herniaNSQIPOutcomes

Identifiers

PMID27438793
OpenAlexW2487239643

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.