title: Association between thoracic aortic disease and inguinal hernia.
abstract: BACKGROUND
  The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher-than-expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population-based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance.
  
  
  RESULTS
  The prevalence of inguinal hernia in subjects with TAD was determined from nation-wide register data and compared to a non-TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non-TAD, P=0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non-TAD, P<0.001. Variables independently associated with hernia in multivariable analysis were male sex (odds ratio [OR] with 95% confidence interval [95% CI]) 3.4 (2.1 to 5.4), P<0.001; increased age, OR 1.02/year (1.004 to 1.04), P=0.014; and TAD, OR 1.8 (1.1 to 2.8), P=0.015.
  
  
  CONCLUSIONS
  The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non-TAD. TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study.
authors.affiliation: Cardiovascular Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden (C.O., A.F.C.).
authors.forename: Christian
authors.initials: C
authors.lastname: Olsson
authors.affiliation: Atherosclerosis Research Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden (P.E.).
authors.forename: Per
authors.initials: P
authors.lastname: Eriksson
authors.affiliation: Cardiovascular Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden (C.O., A.F.C.).
authors.forename: Anders
authors.initials: A
authors.lastname: Franco-Cereceda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008382:Marfan Syndrome / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012737:Sex Factors
keywords: aneurysm; aorta; risk factors; surgery