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

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.