Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 West Markham St. Slot 520-1, Little Rock, AR, 72205, USA.
Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA.
Hernia. 2023 Jun;27(3):541-547. doi: 10.1007/s10029-022-02643-5. Epub 2022 Jun 28.
The aim of this project was to compare patient characteristics, overall efficacy, and readmission events following operative vs non-operative management modalities of non-elective patients presenting with symptomatic incisional hernias.
This study is a retrospective study of patients and patient demographics that presented as non-elective hospitalizations with symptomatic incisional hernia. Analysis of patients and characteristics utilized the National Readmission Database from 2010 to Q3 of 2015, delineating patient factors and outcomes following operative or non-operative management of hernias.
A total of 14,137 patients met inclusion criteria for our study. The majority of patients were treated operatively rather than non-operatively (79 vs. 21%) on their non-elective admission for incisional hernia. Those undergoing surgical management were younger (56 vs 61 years, p < 0.01), we more often of male gender (69 vs 64%, p < 0.01), and had fewer comorbidities (1.92 vs 2.97, p < 0.01) and chronic conditions (0.45 vs 2.68, p < 0.01). Patients managed operatively had a significantly lower readmission rate when compared to patients managed non-operatively (6.6 vs 14.3%, p < 0.01). However, non-operative management was associated with a shorter length of stay (3 vs 4 days, p < 0.01). Of patients who were initially medically managed and had to be readmitted, a further 61% underwent surgical treatment on their readmission.
In this nationwide study, patients with non-elective admissions for incisional hernia were mostly managed surgically. Those managed operatively had lower rates of readmission when compared to non-operative management. Initial non-operative management was associated with a shorter length of stay and a lower cost to the patient. The results of this study support operative management of symptomatic incisional hernia.
本项目旨在比较非择期就诊的症状性切口疝患者接受手术与非手术治疗方式的患者特征、总体疗效和再入院事件。
本研究回顾性分析了 2010 年至 2015 年第三季度非择期住院伴有症状性切口疝的患者和患者人口统计学资料。分析了患者特征和结局，包括利用国家再入院数据库对接受手术或非手术治疗疝的患者进行描述。
共有 14137 例患者符合本研究的纳入标准。在非择期因切口疝入院的患者中，大多数患者接受了手术治疗（79%比 21%）。接受手术治疗的患者更年轻（56 岁比 61 岁，p<0.01），更多为男性（69%比 64%，p<0.01），合并症更少（1.92 比 2.97，p<0.01）和慢性病更少（0.45 比 2.68，p<0.01）。与接受非手术治疗的患者相比，接受手术治疗的患者再入院率显著降低（6.6%比 14.3%，p<0.01）。然而，非手术治疗的住院时间更短（3 天比 4 天，p<0.01）。在最初接受药物治疗并需要再次入院的患者中，进一步的 61%在再次入院时接受了手术治疗。
在这项全国性研究中，非择期就诊的切口疝患者大多接受了手术治疗。与非手术治疗相比，手术治疗的患者再入院率较低。初始非手术治疗与较短的住院时间和较低的患者费用相关。本研究结果支持对症状性切口疝进行手术治疗。
