Highlights
- •Emergent hiatal hernia repair is historically a morbid procedure.
- •Mortality rates were low across all datasets, but higher than for elective repair.
- •Complication rates and number of comorbidities were higher for those who died.
- •Most individuals who had emergent surgery received a minimally invasive repair.
- •Open surgery is independently associated with mortality after hiatal hernia repair.
Abstract
Background
Risk factors for mortality following emergent hiatal hernia (HH) repair in the era
of minimally invasive surgery remain poorly defined.
Methods
Data was obtained from the National Inpatient Sample (NIS), National Readmissions
Database, and National Emergency Department Sample for patients undergoing HH repair
between 2010 and 2018. Univariate and multivariate logistic regression analyses reported
with odds ratio (OR) and 95% confidence intervals (CI) were performed to identify
factors associated mortality.
Results
Via the NIS, mortality rate was 2.2% (147 patients). Via the NEDS, the mortality rate
was 3.6% (303 patients). On multivariate analysis, predictors of mortality included
age (OR 1.05, CI: 1.04,1.07), male sex (OR 1.49, CI: 1.06,2.11), frailty (OR 2.49,
CI: 1.65,3.75), open repair (OR 3.59, CI: 2.50,5.17), and congestive heart failure
(OR 2.71, CI: 1.81,4.06).
Conclusions
There are multiple risk factors for mortality after hiatal hernia repair. There is
merit to a laparoscopic approach even in emergent settings.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 10, 2023
Accepted:
January 9,
2023
Received in revised form:
December 6,
2022
Received:
October 28,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
