title: [Strangulated hernia. Still fatal in the XXI century?].
abstract: BACKGROUND
  Knowledge of the risk factors that may lead to complications after emergency hernia repair is of great importance, as much for the prioritisation of the elective surgery, as selecting those cases that require clinical follow up.
  
  
  OBJECTIVE
  To analyse the factors conditioning the morbidity and mortality of bowel resection associated to emergency hernia repair.
  
  
  METHODS
  A retrospective review was carried out on the clinical histories of patients who had emergency operations for hernia problems from January 2000 to December of 2005. The clinical results obtained were compared based on whether or not a bowel resection was required.
  
  
  RESULTS
  A total of 2367 patients were operated for hernia in this period, 362 of them (15.3%); for a complicated hernia (mean age 69.5 years; 146 males/216 females); 60 patients needed bowel resection. Complications appeared in 108 patients (29.8%) and 17 (4.7%) died after operation. The limit of 70 years discriminated a significantly greater mortality (> 70: 7% vs < 70 2%; p = 0.01). The group of patients who needed bowel resection showed differences in statistical analysis both in age (75.4 vs 68.3 years; p = 0.002), prevalence of complications (40.7% vs 6.2%; p < 0.0001), and mortality (20% vs 1.6%; p < 0.0001). The discriminant analysis identified bowel resection as the only predictive independent variable of mortality (lambda Wilks = 0.89; p = 0.0001; predictive value, 85%).
  
  
  CONCLUSIONS
  Morbidity and the mortality of urgent hernia surgery, when bowel resection was required, are elevated; especially in older patients, and in crural hernias.
authors: Servicio de Cirugía General y Digestiva, Hospital del Mar, Departamento de Cirugía, Universidad Autónoma de Barcelona, Barcelona, España.
authors: M Angeles
authors: MA
authors: Martínez-Serrano
authors: Jose Antonio
authors: JA
authors: Pereira
authors: Juan José
authors: JJ
authors: Sancho
authors: Silvia
authors: S
authors: Salvans
authors: Valentín
authors: V
authors: Juncá
authors: Marcelo
authors: M
authors: Segura
authors: Jordi
authors: J
authors: Solsona
authors: Luis
authors: L
authors: Grande-Posa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies