Risk factors for incarceration in groin hernia: a prospective observational study

Abstract

Purpose: Groin hernia is one of the most common benign pathologies requiring surgical intervention. Incarcerated groin hernia is a cause of serious morbidity and mortality. In our study, we aimed to identify the risk factors for incarceration in patients with groin hernia and to better understand the factors associated with incarceration, we studied patients who applied to our clinic for groin hernia and underwent surgery. Methods: A prospective observational study was performed, including all patients who applied to the general surgery out patient clinic or emergency department at Bakirköy Dr Sadi Konuk Training & Research Hospital and were diagnosed with groin or incarcerated groin hernia and underwent hernia repair surgery. Patients were divided into two groups; elective surgery and emergency surgery (incarcerated hernia). Multivariate logistic regression was performed to identify risk factors for incarceration. Results: The study was performed with a total of 654 cases between January 2021 and February 2023. Of these, 79.4% (n = 519) had elective surgery and 20.6% (n = 135) had emergency surgery. Increase in defect width, which was determined according to the EHS classification, was significantly associated with an incarcerated hernia (ODDS ratio 4.463 and 17.636, respectively). Additionally, female gender, femoral hernia type, chronic cough, and chronic constipation were found to be independent risk factors for incarceration. Conclusion: Female gender, chronic cough, chronic constipation, femoral hernia type, and increased defect diameter are independent risk factors for urgent surgery and therefore incarceration in groin. Trial registration number: The ClinicalTrials.gov ID number of the study is NCT04785430.