Lindsey L Wolf1,2,3, Kristin A Sonderman4,5,6,7, Nicollette K Kwon1,2, Lindsey B Armstrong8, Brent R Weil8, Tracey P Koehlmoos9, Elena Losina10, Robert L Ricca9, Christopher B Weldon8, Adil H Haider1,2,3, Samuel E Rice-Townsend8. 1. Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 2. Harvard T.H. Chan School of Public Health, Boston, MA, USA. 3. Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. 4. Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. kristin.sonderman@umm.edu. 5. Harvard T.H. Chan School of Public Health, Boston, MA, USA. kristin.sonderman@umm.edu. 6. Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. kristin.sonderman@umm.edu. 7. , 22 S. Greene St., Baltimore, MD, 21201, USA. kristin.sonderman@umm.edu. 8. Department of Surgery, Boston Children's Hospital, Boston, MA, USA. 9. Uniformed Services University of the Health Sciences, Bethesda, MD, USA. 10. Orthopaedic and Arthritis Center for Outcomes Research and Policy, Department of Orthopedic Surgery, Brigham and Women's Hospital, Innovation Evaluation in Orthopedic Treatments Research Center, Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: We sought to estimate the prevalence, incidence, and timing of surgery for elective and non-elective hernia repairs. METHODS: We performed a retrospective cohort study, abstracting data on children < 18 years from the 2005-2014 DoD Military Health System Data Repository, which includes > 3 million dependents of U.S. Armed Services members. Our primary outcome was initial hernia repair (inguinal, umbilical, ventral, or femoral), stratified by elective versus non-elective repair and by age. We calculated prevalence, incidence rate, and time from diagnosis to repair. RESULTS: 19,398 children underwent hernia repair (12,220 inguinal, 5761 umbilical, 1373 ventral, 44 femoral). Prevalence of non-elective repairs ranged from 6% (umbilical) to 22% (ventral). Incidence rates of elective repairs ranged from 0.03 [95% CI: 0.02-0.04] (femoral) to 8.92 [95% CI: 8.76-9.09] (inguinal) per 10,000 person-years, while incidence rates of non-elective repairs ranged from 0.005 [95% CI: 0.002-0.01] (femoral) to 0.68 [95% CI: 0.64-0.73] (inguinal) per 10,000 person-years. Inguinal (median = 20, interquartile range [IQR] = 0-46 days), ventral (median = 23, IQR = 5-62 days), and femoral hernias (median = 0, IQR = 0-12 days) were repaired more promptly and with less variation than umbilical hernias (median = 66, IQR = 23-422 days). CONCLUSIONS: These data describe the burden of hernia repair in the U.S. The large variation in time between diagnosis and repair by hernia type identifies an important area of research to understand mechanisms underlying such heterogeneity and determine the ideal timing for repair. LEVEL OF EVIDENCE: Prognosis study II.
PURPOSE: We sought to estimate the prevalence, incidence, and timing of surgery for elective and non-elective hernia repairs. METHODS: We performed a retrospective cohort study, abstracting data on children < 18 years from the 2005-2014 DoD Military Health System Data Repository, which includes > 3 million dependents of U.S. Armed Services members. Our primary outcome was initial hernia repair (inguinal, umbilical, ventral, or femoral), stratified by elective versus non-elective repair and by age. We calculated prevalence, incidence rate, and time from diagnosis to repair. RESULTS: 19,398 children underwent hernia repair (12,220 inguinal, 5761 umbilical, 1373 ventral, 44 femoral). Prevalence of non-elective repairs ranged from 6% (umbilical) to 22% (ventral). Incidence rates of elective repairs ranged from 0.03 [95% CI: 0.02-0.04] (femoral) to 8.92 [95% CI: 8.76-9.09] (inguinal) per 10,000 person-years, while incidence rates of non-elective repairs ranged from 0.005 [95% CI: 0.002-0.01] (femoral) to 0.68 [95% CI: 0.64-0.73] (inguinal) per 10,000 person-years. Inguinal (median = 20, interquartile range [IQR] = 0-46 days), ventral (median = 23, IQR = 5-62 days), and femoral hernias (median = 0, IQR = 0-12 days) were repaired more promptly and with less variation than umbilical hernias (median = 66, IQR = 23-422 days). CONCLUSIONS: These data describe the burden of hernia repair in the U.S. The large variation in time between diagnosis and repair by hernia type identifies an important area of research to understand mechanisms underlying such heterogeneity and determine the ideal timing for repair. LEVEL OF EVIDENCE: Prognosis study II.
Authors: Kate A Stewart; Patricia C Higgins; Catherine G McLaughlin; Thomas V Williams; Elder Granger; Thomas W Croghan Journal: Arch Pediatr Adolesc Med Date: 2010-06-07
Authors: Cheryl K Zogg; Wei Jiang; Muhammad Ali Chaudhary; John W Scott; Adil A Shah; Stuart R Lipsitz; Joel S Weissman; Zara Cooper; Ali Salim; Stephanie L Nitzschke; Louis L Nguyen; Lorens A Helmchen; Linda Kimsey; Samuel T Olaiya; Peter A Learn; Adil H Haider Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313