Hernias of the abdominal wall in patients over the age of 70 years

Abstract

Objective: To find out if the patients' age affects the treatment of abdominal hernias and the results in relation of the age increase. Design: Retrospective and prospective study. Setting: University hospital, Spain. Subjects: 664 patients aged 70 years or more operated on for abdominal hernia between 1986-1998. Patients were divided into three groups: 443 aged 70-79; 202 aged 80-89; and 19 patients aged 90 years or more. Main outcome measures: Perioperative risk, type of surgery and deaths. Results: 117 women (52%) had femoral hernias, compared with 32 men (7%) (p = 0.0001). The incidence of femoral hernia over 80 years of age was 79/221 (36%) compared with 70/443 (16%) among patients in their seventies (p = 0.0001). 97 of the patients aged 70-79 (22%) were operated on as emergencies, 107 of those aged 80-89 (53%), and 17 in patients 90 or older (89%, p = 0.0001). The mortality rate was 1% in the 70-79 group (n = 6), 5% (n = 10) in the 80-89 group, and 3/19 died in the over 90 group (p = 0.0001). No deaths were reported after elective surgery. Conclusion: Emergency operations in elderly patients with abdominal wall hernias are increasingly more common as the patient get older. As result, there is an unacceptable increase in postoperative mortality.