ArticleHernia : the journal of hernias and abdominal wall surgery2026
Emergency repair of incarcerated groin hernias in older adults: a retrospective cohort study of outcomes.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEmergency surgery for incarcerated groin hernias (IGH) in older adults is associated with high morbidity. While age is a known factor, the impact of physiological reserve and functional frailty on outcomes remains poorly quantified.
objectiveTo evaluate the impact of comorbidity burden and frailty on postoperative outcomes in older adults (≥65 years) undergoing emergency IGH repair, compared to a younger cohort (<65 years).
methodsThis retrospective cohort study included 135 consecutive patients (older adults, n=62; younger patients, n=73). Baseline risk was assessed using the Charlson Comorbidity Index (CCI) and Clinical Frailty Scale (CFS). Primary outcome was 30-day mortality; secondary outcomes included complications and ICU admission.
resultsOlder adults had significantly higher physiological and functional risk profiles compared to younger patients (Mean CCI: 4.6±1.3 vs. 1.7±1.1, p<0.001; Mean CFS:4.9±1.2 vs. 2.4±0.8, p<0.001). Intestinal obstruction was more prevalent in older adults(64.5% vs. 35.6%, p=0.001). While overall complication rates were similar (19.4% vs.16.4%, p=0.677), all 30-day mortalities (n=6, 4.4% total) occurred in the older adult group (9.7% vs. 0.0%, p=0.008). Mortality was primarily driven by cardiopulmonary failure, directly correlating with higher CCI and CFS scores.
conclusionsIn emergency IGH repair, 30-day mortality in older adults is driven by diminished physiological reserve and frailty rather than surgical technique. CCI and CFS are sensitive predictors of poor outcomes. High-risk patients (CFS ≥5 or CCI ≥4) require intensive perioperative optimization and closer postoperative monitoring.
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