title: Improved outcomes of incarcerated femoral hernia: a multivariate analysis of predictive factors of bowel ischemia and potential impact on postoperative complications.
abstract: BACKGROUND
  Although much of the literature focuses on risk factors for intestinal resection in groin hernias, little is known specifically for the femoral type. This study identifies clinical and analytic parameters associated with intestinal ischemia in patients with an incarcerated femoral hernia.
  
  
  METHODS
  Eighty-six patients with an incarcerated femoral hernia were included in an analytic, longitudinal, observational, retrospective cohort study. Clinical presentation, the duration of symptoms, analytic and radiologic studies, complications, and mortality rates were analyzed.
  
  
  RESULTS
  Eight (9.3%) patients underwent intestinal resection. Factors related to intestinal ischemia were oral anticoagulants intake (odds ratio = 9.6) and a duration of symptoms longer than 3 days (odds ratio = 2.1). There was no relationship between leukocytosis (P = .02) or radiographic signs of intestinal obstruction (P = .28) and bowel resection.
  
  
  CONCLUSIONS
  Patients with a duration of symptoms longer than 3 days and, interestingly, those having oral anticoagulant therapy appeared to be at a higher risk for developing intestinal ischemia. A remarkable reduction in morbimortality can be achieved through an earlier referral to the hospital, quick preoperative workup, and urgent operation.
authors.affiliation: Department of General and Digestive Surgery, Hospital General La Mancha, Centro Avenida de la Constitución, Ciudad Real, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Alhambra-Rodriguez de Guzmán
authors.forename: Joaquín
authors.initials: J
authors.lastname: Picazo-Yeste
authors.forename: Jose María
authors.initials: JM
authors.lastname: Tenías-Burillo
authors.forename: Carlos
authors.initials: C
authors.lastname: Moreno-Sanz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D006550:Hernia, Femoral / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000401:mortality; D006769:Hospitals, General; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis / Q000517:prevention & control; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000925:Anticoagulants