A nation-wide population-based study of inguinal hernia repair incidence and age-stratified recurrence in an Asian population.
OBJECTIVE
It has been estimated in the UK that 27 % of men and 3 % of women will undergo an inguinal hernia repair (IHR) during their lifetimes. However, no epidemiologic study investigating IHR has been performed to date in an Asian population. The present study explored the incidence and recurrence of IHR in an Asian population using a nation-wide population-based dataset in Taiwan.


METHODS
Based on the National Health Insurance Database, we identified 5806 patients who underwent an IHR between 2000 and 2010 and followed them until they had a recurrence, died during hospitalization, left the program, or the study ended. We calculated the age-stratified recurrence rates and used Cox proportional hazards to explore the influence of demographic and clinical factors on recurrence. We also plotted IHR occurrence over the study period.


RESULTS
Among the 5806 sampled subjects who had an IHR, 565 (9.73 %) had an IHR recurrence yielding an overall incidence of 18.23 per 1000 person-years. The hazard ratios for recurrence increased with age, and were greater among men and blue collar workers. The incidence of IHR decreased from 168.21 to 92.10 per 100,000 person-years over the study period. Surgical complication rates ranged between 0.16 and 2.57 %.


CONCLUSIONS
On account of the increased risk of recurrence with age, young hernia patients may not want to delay surgery. This study detected a decreasing trend in initial IHR rates, confirming similar trends reported in Western countries. However, the incidence of initial IHR is lower in Taiwan than it is in the West.
School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.
J J
JJ
Keller
Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan.|Department of Public Health, China Medical University and Hospital, Taichung, Taiwan.
C-H
CH
Muo
Department of Health Risk Management, China Medical University, Taichung, Taiwan.
Y-C
YC
Lan
Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.
F-C
FC
Sung
Department of Leisure and Recreation Management, Asia University, Taichung, Taiwan.
F-E
FE
Lo
Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
K-Y
KY
Chiang
School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan. sylyu@tmu.edu.tw.|Indigenous Health and Preventive Medicine Research Center, Taipei Medical University, Taipei, Taiwan. sylyu@tmu.edu.tw.
S-Y
SY
Lyu
Division of General Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei, Taiwan. james4120@hotmail.com.|Indigenous Health and Preventive Medicine Research Center, Taipei Medical University, Taipei, Taiwan. james4120@hotmail.com.
S-T
ST
Tsai
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000601:surgery*; D059685:Herniorrhaphy; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012306:Risk; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
Age-stratified; Inguinal hernia; Inguinal hernia repair incidence; Recurrence