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01.11.2008 | ssat poster presentation | Ausgabe 11/2008

Journal of Gastrointestinal Surgery 11/2008

Inpatient Mortality Analysis of Paraesophageal Hernia Repair in Octogenarians

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 11/2008
Autoren:
Benjamin K. Poulose, Christine Gosen, Jeffrey M. Marks, Leena Khaitan, Michael J. Rosen, Raymond P. Onders, Joseph A. Trunzo, Jeffrey L. Ponsky
Wichtige Hinweise
This work was not supported by a research grant.
This work was presented at the 49th annual meeting of the Society for Surgery of the Alimentary Tract, May 19, 2008, San Diego, CA.

Abstract

Introduction

Paraesophageal hernia repair is often performed in an elderly population. Few studies have evaluated perioperative mortality in this group. We identified predictors of inpatient mortality using a nationally representative sample.

Methods

Patients ≥80 years old undergoing transabdominal paraesophageal hernia repair were identified in the 2005 Nationwide Inpatient Sample. Congenital diaphragmatic defects and traumatic injuries were excluded.

Results

One thousand five discharges (73% female) with mean age 84.7 met inclusion criteria. Mean length of stay was 10.1 days (95% confidence interval 8.9–11.3) with a mortality of 8.2%. Non-elective repair was performed in 43%. For these patients, mortality and mean length of stay (16%; 14.3 days) were increased compared to elective repair (2.5%; 7.0 days, p < 0.05). Non-elective repair was the sole predictor of inpatient mortality in adjusted analyses (odds ratio 7.1, 95% confidence interval 1.9–26.3, p < 0.05).

Conclusion

Non-elective repair was associated with a six to sevenfold increase in mortality and longer length of stay. Earlier elective repair of paraesophageal hernia may reduce mortality.

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