72258 - Inguinal hernia repair during the COVID-19 pandemic – a nationwide, retrospective cohort study from Swedish Hernia Register
Ramia Stolt, Peder Rogmark, Fernando Ruiz, Kristina Ticehurst, Johanna Österberg, Hanna De la CroixAbstract
Introduction
Over 16 000 inguinal hernia repairs (IHR) are annually performed in Sweden, mainly in elective daycare setting. During COVID-19 pandemic all elective surgeries in Sweden were initially postponed to reallocate sources and reduce the spreading. Our aim is to study the impact of the COVID-19 pandemic on IHR in Sweden based on a nationwide, retrospective cohort.
Method
A retrospective, observational cohort based upon data from the Swedish Hernia Register (SHR) to compare the quality of IHR in Sweden before and during the Coivd-19-pandemic. The results are presented according to STROBE checklist after using multivariate logistic regression analysis to calculate the complication risks in short- and long-term.
Result
109461 hernia repairs were registered in SHR between 2015-2021. The elective IHRs decreased by 22,3% in 2020. Subsequently, the percentage of acute IHRs increased only by 0.9% during the pandemic. However, the risk of getting an acute IHR was slightly increased in the later cohort (OR 1.24) and main risk factors were female gender (OR=3.28, p<0,001), age >70 years (p<0.001) and ASA class >3 (p<0.001). Acute IHR was also highly associated with severe postoperative complications (Clavien-Dindo 3b-5) and 30-days mortality in both cohorts (OR 3.94, p<0.001).
Discussion
The number of acute hernia repairs seems to be independent of number of elective hernia surgery. The risk of emergency surgery increased slightly during the Covid-pandemic (R 1.24), but despite that no significant differences could be shown in mortality rates or risk of severe complication between the cohorts. Further time is needed to study risk of reoperation.