title: Prognostic value of age for chronic postoperative inguinal pain.
abstract: OBJECTIVE
  Chronic postoperative inguinal pain (CPIP) is considered the most common and serious long-term problem after inguinal hernia repair. Young age has been described as a risk factor for developing chronic pain after several surgical procedures. Our aim was to assess if age has prognostic value on CPIP.
  
  
  METHODS
  The database of a randomized trial; the LEVEL trial, 669 patients, TEP versus Lichtenstein, was used for analysis. Data on incidence and intensity of preoperative pain, postoperative pain and CPIP at 1 year were collected. The association of age with incidence and intensity of pain was assessed with regression analysis. Further, hernia type and surgical technique were studied in combination with age and CPIP as possible risk factors on CPIP over age alone.
  
  
  RESULTS
  Younger patients (18-40 years) presented more often with CPIP than middle-aged patients (40-60 years) and elderly (>60 years); 43 vs. 29 vs. 19 %; overall 27 %. Younger and middle-aged patients had more frequently preoperative pain; 54 vs. 55 vs. 41 % and intensity of pain was higher during the first three postoperative days (VAS on day 1: 5.5 vs. 4.5 vs. 3.9 and on day 3: 3.8 vs. 2.9 vs. 2.6). Indirect-type hernias were seen more often in younger patients (77 vs. 51 vs. 48 %) and were not related to CPIP or with surgical technique.
  
  
  CONCLUSIONS
  Almost one out of three patients experiences CPIP. The younger the patient, the higher the risk of CPIP. Hernia type and surgical technique did not influence CPIP.
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands, hesterlangeveld@hotmail.com.
authors.forename: H R
authors.initials: HR
authors.lastname: Langeveld
authors.forename: P
authors.initials: P
authors.lastname: Klitsie
authors.forename: H
authors.initials: H
authors.lastname: Smedinga
authors.forename: H
authors.initials: H
authors.lastname: Eker
authors.forename: M
authors.initials: M
authors.lastname: Van't Riet
authors.forename: W
authors.initials: W
authors.lastname: Weidema
authors.forename: Y
authors.initials: Y
authors.lastname: Vergouwe
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
authors.forename: J
authors.initials: J
authors.lastname: Jeekel
authors.forename: J F
authors.initials: JF
authors.lastname: Lange
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D011379:Prognosis; D055815:Young Adult
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