Surgical intervention reduced the likelihood of hospital readmission compared to nonoperative management of inguinal hernia, according to a new study.

Researchers at the University of Arkansas for Medical Sciences (Little Rock, USA) conducted a retrospective review of 2010-2014 data from the Nationwide Readmissions Database regarding 14,249 adult patients admitted non-electively for a primary diagnosis of inguinal hernia; readmissions within 90 days of the initial visit were flagged. The patients were classified according to initial management strategy - operative (63.13%) versus non-operative (36.88%). Demographic, clinical, and organizational characteristics were compared between the two cohorts.

The results revealed that when comparing the two groups, readmission rate was lower (0.49% for surgical, 1.78% for non-surgical), mean length of stay (LOS) longer (3.27 days for surgical, 2.76 days for non-surgical), and mean total cost was higher (USD 9,597 for surgical and 7,167 for non-surgical). The non-surgical population was on average older, and suffered from more chronic conditions. Of the readmitted patients, 62% were managed surgically within 90 days of initial admission. The study was published on July 27, 2021, in Hernia.

“While the percentage of readmitted patients who were initially managed non-operatively is low, readmission is still more than three and a half times more likely if the hernia was initially managed without surgery, compared to those who were initially fixed,” said study co-author Avi Bhavaraju, MD. “We can therefore reasonably conclude that patients with symptomatic inguinal hernias would probably benefit from having their hernias repaired during the index admission.”

An inguinal hernia is a protrusion of abdominal cavity contents through the inguinal canal. A bulging area may occur that becomes larger when bearing down. Symptoms may include pain or discomfort, especially with coughing, exercise, or bowel movements. Treatment options include a “wait and see” approach and open or minimally invasive surgery. 

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