Hernia recurrence following inguinal hernia repair in children |
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Authors: | Kathryn Taylor Kristin A Sonderman Lindsey L Wolf Wei Jiang Lindsey B Armstrong Tracey P Koehlmoos Brent R Weil Robert L Ricca Christopher B Weldon Adil H Haider Samuel E Rice-Townsend |
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Institution: | 1. Harvard Medical School, Boston, MA;2. Center for Surgery and Public Health, Brigham and Women''s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, MA;3. Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, Brigham and Women''s Hospital, Boston, MA;4. Department of Surgery, Boston Children''s Hospital, Boston, MA;5. Uniformed Services University of the Health Sciences, Bethesda, MD |
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Abstract: | PurposeWe aimed to describe the incidence, timing, and predictors of recurrence following inguinal hernia repair (IHR) in children.MethodsWe used the TRICARE claims database, a national cohort of > 3 million child dependents of members of the U.S. Armed Forces. We abstracted data on children < 12y who underwent IHR (2005–2014). Our primary outcome was recurrence (ICD9-CM diagnosis codes). We calculated incidence rates for the population and stratified by age, time from repair to recurrence, and multivariable logistic regression to determine predictors.ResultsNine thousand nine hundred ninety-three children met inclusion criteria. Age at time of IHR was ≤ 1y in 37%, 2-3y in 23%, 4–5y in 16%, and 5–12y in 24%. Median follow-up time was 3.5y (IQR:1.6–6.1). 137 patients recurred (1.4%), with an incidence of 3.46 per 1000 person-years. Over half occurred in children 0-1y at repair (60%). The majority occurred within a year following repair (median 209?days IQR:79–486]). Children 0-1y had 2.53 times greater odds of recurrence (compared to > 5y). Children with multiple comorbidities had 5.45 times greater odds compared to those with no comorbidities.ConclusionsThe incidence of recurrence following IHR is 3.46 per 1000 person-years. The majority occurred within a year of repair. Children ≤ 1y and those with multiple comorbidities were at increased risk.Level of EvidencePrognosis Study, Level II. |
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Keywords: | Inguinal hernia Hernia recurrence Pediatric hernia |
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