title: Risk factors for complications in groin hernia surgery: a national register study.
abstract: OBJECTIVE
  This study aims to analyze and identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication.
  
  
  BACKGROUND
  The outcome of groin hernia surgery is evaluated mostly by comparing recurrence rates and long-term pain. The aim of this observational population-based registry study was to identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication.
  
  
  METHODS
  Using data from the nationwide Swedish Hernia Register between 1998 and 2009, 150,514 herniorrhaphies were analyzed with respect to postoperative complications occurring within 30 days of surgery.
  
  
  RESULTS
  Risk factors significantly affecting the rate of postoperative complications were laparoscopic repair (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.24-1.47) and open preperitoneal techniques (OR: 1.31, 95% CI: 1.15-1.49), with open anterior mesh as reference category. Other significant risk factors were general (OR: 1.30, 95% CI: 1.23-1.37) and regional anesthesia (OR: 1.53, 95% CI: 1.43-1.63), with local anesthesia as reference category, emergency procedures (OR: 1.53, 95% CI: 1.43-1.63); recurrent hernia repair (OR: 1.39, 95% CI: 1.27-1.52); femoral hernia (OR: 1.30, 95% CI: 1.14-1.48); aged older than 65 years (OR: 1.26, 95% CI: 1.21-1.31); and duration of surgery exceeding 50 minutes (OR: 1.27, 95% CI: 1.22-1.33).
  
  
  CONCLUSIONS
  Open anterior approach and surgery under local anesthesia are associated with less risk of postoperative complications.
authors.affiliation: Department of Surgery, Östersunds Hospital, Östersund, Sweden.
authors.forename: Karl-Johan
authors.initials: KJ
authors.lastname: Lundström
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sandblom
authors.forename: Sam
authors.initials: S
authors.lastname: Smedberg
authors.forename: Pär
authors.initials: P
authors.lastname: Nordin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006550:Hernia, Femoral / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D012086:Reoperation; D012307:Risk Factors