Factors influencing morbidity and mortality in elderly population undergoing inguinal hernia surgery

Objective: To study various factors influencing outcome of open hernia repair in elderly population. Methods: This is a retrospective descriptive study from January 2004 to December 2008 including all patients (n=212) of 60 years and above operated for inguinal hernias either electively or in emergency during this period. One of the co-authors was assigned the duty to collect the record files of all patients over 60 years age operated for inguinal hernia in the department of surgery LUMHS as well as in private hospitals in Hyderabad. The records of all patients were reviewed and data retrieved on a proforma mentioning variables to investigate the common co-morbidities and their influence on the overall results of surgical intervention in geriatric patients. SPSS version 12 was used for statistical analysis of the data. Results: The mean age of the patients in this series was 69.82 +/- 7.8 years of whom 208(98%) were males and 4 (2%) females. In 190 (89.61%) patients the hernias were unilateral while 12 (5.7%) cases had bilateral inguinal hernias and 10 (4.7%) patients presented with recurrent hernias. In 159 (75%) patients the hernia was simple while 53 (25%) patients presented with one or the other complication such as obstruction or strangulation. Elective surgery was performed in 161(75.9%) patients while 51 (24.1%) patients were operated in emergency. Co-morbidities were present in 79 (37.26%) patients. Out of the total study population, 7(3.30%) patients died of which 6 were operated in emergency and had co-morbidities. All of them had gangrene of bowel for which resection and anastomosis was done. One patient died of acute MI on 5th post-operative day. Conclusion: Emergency hernia surgery carries a high mortality in elderly patients. Co-existing medical problems make surgery still challenging in the geriatric population. An early elective hernia repair is highly recommended (JPMA 60:45; 2010).