Patient-reported adverse events after hernia surgery and socio-economic status: A register-based cohort study

Wefer, Agnes; Gunnarsson, Ulf; Fränneby, Ulf; Sandblom, Gabriel

doi:10.1016/j.ijsu.2016.09.079

Cited by 8 publications

(6 citation statements)

References 11 publications

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“… 6 , 8 , 9 However, a qualitative study from Sweden, a country with universal health care, showed no association between lower SES and worse outcomes of inguinal hernia repair. 20 …”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status does not influence the presentation of patients with inguinal hernia at an urban Canadian teaching hospital

Laane

Chen

Rosenkrantz

et al. 2022

cjs

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Background: Socioeconomic status (SES) has been shown to influence the outcomes of surgical pathologies in areas with unequal access to health care. The purpose of this study was to measure the effect of SES on the urgency for inguinal hernia repair in an area with purported equitable access to health care in the context of a universal health care system. Methods: We included all adult patients who underwent surgical management of an inguinal hernia between 2012 and 2016 at 2 urban academic centres. We measured the SES using the Vancouver Area Neighbourhood Deprivation Index (VANDIX) score. Results: We included 2336 patients: 98 emergency surgery and 294 elective surgery cases. We matched patients without replacement on age, sex and American Society of Anesthesiology score, using optimized propensity score matching at a ratio of 1 case to 3 controls. We found no significant correlation between lower SES and emergency surgical management ( p = 0.122). Secondary analysis assessed the impact of SES on morbidity and length of stay. We found no significant difference in the rate of complications, length of stay and recurrence by SES category. Patients from lower SES brackets had increased odds for readmission (odds ratio 1.979; 95% confidence interval 1.111–4.318). Conclusion: We found no correlation between a low SES and the need for emergency inguinal hernia repair, but found an increased rate of readmission in patients from lower SES brackets. This finding should be further scrutinized through a deeper dive into the barriers to access to nonacute care settings, such as home care.

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“… 6 , 8 , 9 However, a qualitative study from Sweden, a country with universal health care, showed no association between lower SES and worse outcomes of inguinal hernia repair. 20 …”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status does not influence the presentation of patients with inguinal hernia at an urban Canadian teaching hospital

Laane

Chen

Rosenkrantz

et al. 2022

cjs

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“…Socioeconomic factors have been shown to be associated with stoma reversal rate [ 15 , 17 , 18 ]. Income, education and occupation are well-known variables used for classification of socioeconomic status [ 19 , 20 ]. Kuryba et al [ 15 ] evaluated factors affecting stoma reversal rate in 4879 rectal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Loop-ileostomy reversal—patient-related characteristics influencing time to closure

Gustafsson

Gunnarsson

Dahlstrand

et al. 2018

Int J Colorectal Dis

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PurposeTo identify factors associated with timing of stoma reversal after rectal cancer surgery in a large Swedish register-based cohort.MethodsThree thousand five hundred sixty-four patients with rectal cancer who received a protective stoma during surgery in 2007–2013 were identified in the Swedish colorectal cancer register. Time to stoma reversal was evaluated over a follow-up period of one and a half years. Factors associated with timing of stoma reversal were analysed using Cox regression analysis. Reversal within 9 months (12 months if adjuvant chemotherapy) was considered latest expected time to closure.ResultsStoma reversal was performed in 2954 (82.9%) patients during follow-up. Patients with post-secondary education had an increased chance for early stoma reversal (HR 1.13; 95% CI 1.02–1.25). Postoperative complications (0.67; 0.62–0.73), adjuvant chemotherapy (0.63; 0.57–0.69), more advanced cancer stage (stage III 0.74; 0.66–0.83 and stage IV 0.38; 0.32–0.46) and higher ASA score (0.80; 0.71–0.90 for ASA 3–4) were associated with longer time to reversal. Two thousand four hundred thirty-seven (68.4%) patients had stoma reversal within latest expected time to closure. Factors associated to decreased chance of timely reversal were more advanced cancer stage (stage III 0.64; 0.50–0.81 and stage IV 0.19; 0.13–0.27), postoperative complications (0.50; 0.42–0.59) and higher ASA score (0.77; 0.61–0.96 for ASA 3–4).ConclusionsPatients with a high level of education had a higher chance of timely reversal but medical factors had a stronger association to time to reversal. Patients with advanced rectal cancer are at high risk for non-reversal and should be considered for permanent stoma.

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“…When adverse events were studied later, and merged data from the SHR with data from the national patient register, the male gender was found to be associated with an increased risk of both cardiovascular events and intraoperative complications [ 21 ]. A study from 2002 found that although women had neither more registered nor more self-perceived adverse events, they sought healthcare advice regarding their perceived complications more often (in 75% of cases versus 48% for men, p = 0.003) in a study cohort from 2002 [ 22 ]. A tendency, although not statistically significant, for women to file damage claims more often (OR 1.62, 95% CI 0.98–2.71, p = 0.06) after groin hernia surgery was found by Nordin et al, while they were investigating damage claims between 2008 and 2010 [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Female Groin Hernia Repairs in the Swedish Hernia Register 1992–2022: A Review With Updates

Dahlstrand,

Melkemichel,

Österberg

et al. 2023

J. Abdom. Wall Surg.

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Introduction: Groin hernias in women is much less common than in men; it constitutes only 9% of all groin hernia operations. Historically, studies have been performed on men and the results applied to both genders. However, prospectively registered operations within national registers have contributed to new knowledge regarding groin hernias in women. The aim of this paper was to investigate and present a body of literature based upon the Swedish Hernia Register together with recent data from the register’s annual report.Patients and Methods: PubMed and Embase were searched for studies based on the Swedish Hernia Register between 1992 and 2023. Based on the initial reading of abstracts, studies that presented results separately for women were selected and read. Recent data were acquired from the 2022 annual report of the Swedish Hernia Register.Results: A total of 73 studies of interest were identified. Of these, 52 included women, but only 19 presented separate results for women. Four themes emerged and were analysed further: emergency surgery and mortality, femoral hernias, the risk of reoperation for recurrence, and chronic pain following female groin hernia repairs.Discussion: Studies from the Swedish Hernia Register clearly describe that both the presentation of hernias and outcomes after repair differ significantly between the two genders. The differences that have been identified over the years have been incorporated into the national guidelines. Register data indicates that the guidelines have been implemented and are fairly well adhered to. As a result, significant improvements in outcomes regarding recurrences have been made for women with groin hernias in Sweden.

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Patient-reported adverse events after hernia surgery and socio-economic status: A register-based cohort study

Cited by 8 publications

References 11 publications

Socioeconomic status does not influence the presentation of patients with inguinal hernia at an urban Canadian teaching hospital

Socioeconomic status does not influence the presentation of patients with inguinal hernia at an urban Canadian teaching hospital

Loop-ileostomy reversal—patient-related characteristics influencing time to closure

Female Groin Hernia Repairs in the Swedish Hernia Register 1992–2022: A Review With Updates

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