Risk factors for postoperative hematoma after inguinal hernia repair

an update

Muhammad H. Zeb, T. K. Pandian, Moustafa M. El Khatib, Nimesh D. Naik, Abhishek Chandra, David S. Morris, Rory L. Smoot, David R. Farley

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background We recently sensed an increase in the frequency of groin hematoma after inguinal hernia repair (IHR) at our institution. The aim of this study was to provide a more updated assessment of the risk factors inherent to this complication. Methods We performed a case-control study of all adult patients (age ≥ 18 y) who developed a groin hematoma after IHR at our institution between 2003 and 2015. Univariate and multivariable analyses were performed to assess for independent predictors for groin hematoma. Results A total of 96 patients (among 6608 IHR) developed a groin hematoma, (60 were observed, 36 required intervention). The hematoma frequency increased from our previous study (1.4 % versus 0.9%, P < 0.01). Mean age was 64.6 y (range: 18-92), and 84.3% were men. There was no significant difference in the laterality, type, or technique of IHR between cases and controls. Univariate analysis (odds ratio [95% confidence interval], P) identified warfarin usage (3.5, [1.6-6.4], P < 0.01), valvular heart disease (11.6, [2.6-51.3], P < 0.01), atrial fibrillation (2.6, [1.2-5.5], P = 0.01), hypertension (2.03, [1.1-3.6], P = 0.02), recurrent hernia (3.7, [1.4-9.7], P < 0.01), and coronary artery disease (2.1, [1.0-4.4 ], P = 0.05) as significant preoperative factors. The proportion of patients on warfarin decreased since our prior report (31% versus 42%, P = 0.20). On multivariable regression, warfarin and recurrent hernia were independent predictors of hematoma development. Conclusions Independent risk factors for the development of groin hematoma after IHR included warfarin use and recurrent hernia. Careful consideration for anticoagulation and surgical hypervigilance remains prudent in all patients undergoing IHR and especially those with recurrence.

Original languageEnglish (US)
Pages (from-to)33-37
Number of pages5
JournalJournal of Surgical Research
Volume205
Issue number1
DOIs
StatePublished - Sep 1 2016

Fingerprint

Inguinal Hernia
Herniorrhaphy
Hematoma
Groin
Warfarin
Hernia
Heart Valve Diseases
Atrial Fibrillation
Case-Control Studies
Coronary Artery Disease
Anxiety
Odds Ratio
Confidence Intervals
Hypertension
Recurrence

Keywords

  • Anticoagulation
  • Groin hematoma
  • Inguinal hernia
  • Inguinal herniorrhaphy
  • Postoperative hematoma

ASJC Scopus subject areas

  • Surgery

Cite this

Zeb, M. H., Pandian, T. K., El Khatib, M. M., Naik, N. D., Chandra, A., Morris, D. S., ... Farley, D. R. (2016). Risk factors for postoperative hematoma after inguinal hernia repair: an update. Journal of Surgical Research, 205(1), 33-37. https://doi.org/10.1016/j.jss.2016.06.002

Risk factors for postoperative hematoma after inguinal hernia repair : an update. / Zeb, Muhammad H.; Pandian, T. K.; El Khatib, Moustafa M.; Naik, Nimesh D.; Chandra, Abhishek; Morris, David S.; Smoot, Rory L.; Farley, David R.

In: Journal of Surgical Research, Vol. 205, No. 1, 01.09.2016, p. 33-37.

Research output: Contribution to journalArticle

Zeb, MH, Pandian, TK, El Khatib, MM, Naik, ND, Chandra, A, Morris, DS, Smoot, RL & Farley, DR 2016, 'Risk factors for postoperative hematoma after inguinal hernia repair: an update', Journal of Surgical Research, vol. 205, no. 1, pp. 33-37. https://doi.org/10.1016/j.jss.2016.06.002
Zeb MH, Pandian TK, El Khatib MM, Naik ND, Chandra A, Morris DS et al. Risk factors for postoperative hematoma after inguinal hernia repair: an update. Journal of Surgical Research. 2016 Sep 1;205(1):33-37. https://doi.org/10.1016/j.jss.2016.06.002
Zeb, Muhammad H. ; Pandian, T. K. ; El Khatib, Moustafa M. ; Naik, Nimesh D. ; Chandra, Abhishek ; Morris, David S. ; Smoot, Rory L. ; Farley, David R. / Risk factors for postoperative hematoma after inguinal hernia repair : an update. In: Journal of Surgical Research. 2016 ; Vol. 205, No. 1. pp. 33-37.
@article{9f0ef6900bc5409c9657fdf0a373f945,
title = "Risk factors for postoperative hematoma after inguinal hernia repair: an update",
abstract = "Background We recently sensed an increase in the frequency of groin hematoma after inguinal hernia repair (IHR) at our institution. The aim of this study was to provide a more updated assessment of the risk factors inherent to this complication. Methods We performed a case-control study of all adult patients (age ≥ 18 y) who developed a groin hematoma after IHR at our institution between 2003 and 2015. Univariate and multivariable analyses were performed to assess for independent predictors for groin hematoma. Results A total of 96 patients (among 6608 IHR) developed a groin hematoma, (60 were observed, 36 required intervention). The hematoma frequency increased from our previous study (1.4 {\%} versus 0.9{\%}, P < 0.01). Mean age was 64.6 y (range: 18-92), and 84.3{\%} were men. There was no significant difference in the laterality, type, or technique of IHR between cases and controls. Univariate analysis (odds ratio [95{\%} confidence interval], P) identified warfarin usage (3.5, [1.6-6.4], P < 0.01), valvular heart disease (11.6, [2.6-51.3], P < 0.01), atrial fibrillation (2.6, [1.2-5.5], P = 0.01), hypertension (2.03, [1.1-3.6], P = 0.02), recurrent hernia (3.7, [1.4-9.7], P < 0.01), and coronary artery disease (2.1, [1.0-4.4 ], P = 0.05) as significant preoperative factors. The proportion of patients on warfarin decreased since our prior report (31{\%} versus 42{\%}, P = 0.20). On multivariable regression, warfarin and recurrent hernia were independent predictors of hematoma development. Conclusions Independent risk factors for the development of groin hematoma after IHR included warfarin use and recurrent hernia. Careful consideration for anticoagulation and surgical hypervigilance remains prudent in all patients undergoing IHR and especially those with recurrence.",
keywords = "Anticoagulation, Groin hematoma, Inguinal hernia, Inguinal herniorrhaphy, Postoperative hematoma",
author = "Zeb, {Muhammad H.} and Pandian, {T. K.} and {El Khatib}, {Moustafa M.} and Naik, {Nimesh D.} and Abhishek Chandra and Morris, {David S.} and Smoot, {Rory L.} and Farley, {David R.}",
year = "2016",
month = "9",
day = "1",
doi = "10.1016/j.jss.2016.06.002",
language = "English (US)",
volume = "205",
pages = "33--37",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Risk factors for postoperative hematoma after inguinal hernia repair

T2 - an update

AU - Zeb, Muhammad H.

AU - Pandian, T. K.

AU - El Khatib, Moustafa M.

AU - Naik, Nimesh D.

AU - Chandra, Abhishek

AU - Morris, David S.

AU - Smoot, Rory L.

AU - Farley, David R.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background We recently sensed an increase in the frequency of groin hematoma after inguinal hernia repair (IHR) at our institution. The aim of this study was to provide a more updated assessment of the risk factors inherent to this complication. Methods We performed a case-control study of all adult patients (age ≥ 18 y) who developed a groin hematoma after IHR at our institution between 2003 and 2015. Univariate and multivariable analyses were performed to assess for independent predictors for groin hematoma. Results A total of 96 patients (among 6608 IHR) developed a groin hematoma, (60 were observed, 36 required intervention). The hematoma frequency increased from our previous study (1.4 % versus 0.9%, P < 0.01). Mean age was 64.6 y (range: 18-92), and 84.3% were men. There was no significant difference in the laterality, type, or technique of IHR between cases and controls. Univariate analysis (odds ratio [95% confidence interval], P) identified warfarin usage (3.5, [1.6-6.4], P < 0.01), valvular heart disease (11.6, [2.6-51.3], P < 0.01), atrial fibrillation (2.6, [1.2-5.5], P = 0.01), hypertension (2.03, [1.1-3.6], P = 0.02), recurrent hernia (3.7, [1.4-9.7], P < 0.01), and coronary artery disease (2.1, [1.0-4.4 ], P = 0.05) as significant preoperative factors. The proportion of patients on warfarin decreased since our prior report (31% versus 42%, P = 0.20). On multivariable regression, warfarin and recurrent hernia were independent predictors of hematoma development. Conclusions Independent risk factors for the development of groin hematoma after IHR included warfarin use and recurrent hernia. Careful consideration for anticoagulation and surgical hypervigilance remains prudent in all patients undergoing IHR and especially those with recurrence.

AB - Background We recently sensed an increase in the frequency of groin hematoma after inguinal hernia repair (IHR) at our institution. The aim of this study was to provide a more updated assessment of the risk factors inherent to this complication. Methods We performed a case-control study of all adult patients (age ≥ 18 y) who developed a groin hematoma after IHR at our institution between 2003 and 2015. Univariate and multivariable analyses were performed to assess for independent predictors for groin hematoma. Results A total of 96 patients (among 6608 IHR) developed a groin hematoma, (60 were observed, 36 required intervention). The hematoma frequency increased from our previous study (1.4 % versus 0.9%, P < 0.01). Mean age was 64.6 y (range: 18-92), and 84.3% were men. There was no significant difference in the laterality, type, or technique of IHR between cases and controls. Univariate analysis (odds ratio [95% confidence interval], P) identified warfarin usage (3.5, [1.6-6.4], P < 0.01), valvular heart disease (11.6, [2.6-51.3], P < 0.01), atrial fibrillation (2.6, [1.2-5.5], P = 0.01), hypertension (2.03, [1.1-3.6], P = 0.02), recurrent hernia (3.7, [1.4-9.7], P < 0.01), and coronary artery disease (2.1, [1.0-4.4 ], P = 0.05) as significant preoperative factors. The proportion of patients on warfarin decreased since our prior report (31% versus 42%, P = 0.20). On multivariable regression, warfarin and recurrent hernia were independent predictors of hematoma development. Conclusions Independent risk factors for the development of groin hematoma after IHR included warfarin use and recurrent hernia. Careful consideration for anticoagulation and surgical hypervigilance remains prudent in all patients undergoing IHR and especially those with recurrence.

KW - Anticoagulation

KW - Groin hematoma

KW - Inguinal hernia

KW - Inguinal herniorrhaphy

KW - Postoperative hematoma

UR - http://www.scopus.com/inward/record.url?scp=84977269127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977269127&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2016.06.002

DO - 10.1016/j.jss.2016.06.002

M3 - Article

VL - 205

SP - 33

EP - 37

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 1

ER -