Trends in XXXX repair in the United States.

@entity1 @entity4036 @entity341 @entity18659 @entity547
IMPORTANCE: @entity4036 is one of the most common conditions encountered by general surgeons. Rising rates of @entity4036 repair have been described; however, population-based evidence concerning incidence rates of @entity341 repair and changes with time are unknown. OBJECTIVE: To examine trends in rates of emergent @entity4036 repair within the United States for inguinal, femoral, ventral, and umbilical hernias from January 1, 2001, to December 31, 2010. DESIGN, SETTING, AND @entity1 : A retrospective analysis of adults with @entity341 repair using National Center for Health Statistics data, a nationally representative sample of inpatient hospitalizations in the United States that occurred from January 1, 2001, to December 31, 2010. All @entity341 repairs were identified during the study period. MAIN OUTCOMES AND MEASURES: Incidence rates per 100   000 @entity1 -years, age, and sex adjusted to the 2010 US census population estimates were calculated for selected subcategories of @entity341 repairs and time trends were evaluated. RESULTS: An estimated 2.3 million inpatient @entity4036 repairs were performed from 2001 to 2010; of which an estimated 567   000 were performed emergently. A general increase in the rate of @entity341 was observed from 16.0 to 19.2 @entity341 repairs per 100   000 @entity1 -years in 2001 and 2010, respectively. In 2010, @entity341 rates were highest among adults 65 years and older, with 71.3 and 42.0 @entity341 repairs per 100   000 @entity1 -years for @entity1 and @entity1 , respectively. As expected, @entity18659 rates were higher among @entity1 while emergent inguinal @entity547 rates were higher among @entity1 . Rates of emergent incisional @entity547 repair were high but relatively stable among older @entity1 , with 24.9 and 23.5 per 100   000 @entity1 -years in 2001 and 2010, respectively. However, rates of emergent incisional @entity547 repair among older @entity1 rose significantly, with 7.8 to 32.0 per 100   000 @entity1 -years from 2001 to 2010, respectively. CONCLUSIONS AND RELEVANCE: These increasing rates of emergent incisional @entity547 repair are troublesome owing to the significantly increased risk morbidity and mortality associated with @entity341 repair. While this increased mortality risk is multifactorial, it is likely associated with older age and the accompanying serious comorbidities.
