P0956 - Complications following incarcerated inguinal hernia repair in children: A nationwide readmissions analysis

Background/Purpose: Prompt inguinal hernia repair is recommended in children, especially infants, in order to minimize the risk of incarceration and associated complications among patients awaiting inguinal hernia repair. We aim to compare complications and readmissions following inpatient surgery for uncomplicated inguinal hernia and complicated (incarcerated) inguinal hernias.

Methods: The Nationwide Readmissions Database (2010-2014) was queried to identify children (age <18) requiring inpatient inguinal hernia repair. Propensity score matching analyses were performed based upon demographics, co-morbidities, and hospital characteristics. We compared surgery for uncomplicated and complicated inguinal hernias (defined as incarcerated with obstruction and/or gangrene), readmission rate up to one year, and post-operative complications.

Results: We identified 40,820 children diagnosed with an inguinal hernia. Complicated inguinal hernias were present in 7% (1,135) of preterm infants, 19% (3,259) of full-term infants, and 25% (1,797) of children >1 year old. A total of 20,091 children underwent repair of an inguinal hernia [27% (5,412) complicated] during the initial admission. The majority of patients were male (84%) and <1 year old (80%). Children treated for complicated inguinal hernias had similar mortality rates and readmission rates compared to those with uncomplicated inguinal hernias (Table 1). However, patients ≥1 year of age with complicated inguinal hernias more frequently required re-operation for inguinal hernia repair (Table 1). Rates of post-operative wound infection, other infection, septicemia, gastrointestinal disorders, respiratory disorders, and urinary disorders were each higher for premature infants that underwent repair of a complicated inguinal hernia compared to those with uncomplicated inguinal hernias (all p<0.05). However, none of these complications were more common among full-term infants or children ≥1 year old.

Conclusions: Incarcerated inguinal hernias rarely result in increased rates of morbidity among full-term infants and older children. However, re-operation for an inguinal hernia is slightly more common following repair of an incarcerated inguinal hernia in older children.