Emergency Inguinal Hernia Surgery Rates Increased With Lower Country Income

Increase in emergency surgery rates accompanied by increase in bowel resection; complications linked to emergency surgery and bowel resection
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Medically Reviewed By:
Mark Arredondo, M.D.

FRIDAY, May 31, 2024 (HealthDay News) -- For patients undergoing inguinal hernia surgery, emergency surgery rates increase from high- to low-income countries, according to a study published online May 23 in The Lancet Global Health.

Maria Picciochi, Ph.D., from the University of Birmingham in the United Kingdom, and colleagues conducted a prospective, international, cohort study comparing access to and quality of inguinal hernia surgery across World Bank income groups (high, upper middle, lower middle, and low), adjusted for hospital and country. Data were included for 18,058 patients from 640 hospitals in 83 countries; 7.1 percent underwent emergency surgery.

The researchers found an increase in emergency surgery rates from high- to low-income countries (6.8, 9.7, 11.4, and 14.2 percent, respectively), which was accompanied by an increase in bowel resection rates (1.2, 1.4, 2.3, and 4.2 percent). Around the world, the overall waiting times for elective surgery were similar (median, 8.0 months), mainly due to delays between symptom onset and diagnosis rather than waiting for treatment. Mesh use decreased from high- to low-income countries in 14,768 elective operations in adults (97.6, 94.3, 80.6, and 61.0 percent, respectively). Among 12,658 patients eligible for day-case surgery, day-case rates were low and variable (50.0, 38.0, 42.1, and 44.5 percent, respectively). Overall, 13.4 percent of 18,018 patients had complications, which were more common after emergency surgery and bowel resection (adjusted odds ratios, 2.06 and 1.85, respectively) and less common after day-case surgery (adjusted odds ratio, 0.39).

"This study has identified areas for intervention by policy makers. Financing these pathways will be a challenge, especially if elective care needs to compete with emergency care," the authors write.

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