Abstract
Purpose
Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to assess patient’s Quality of Life (QoL) after open inguinal hernia repair and to identify predictors of low QoL at 3 months after surgery, to guide practice and inform patients at high risk.
Methods
Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October–December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors.
Results
893 patients were included from 33 hospitals. The majority were men [89.9% (800/891)], had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair [52.9% (472/893)]. The median QoL score was 24 (IQR 10–40) before surgery and 2 (IQR 0–10) at 3 months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21–2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12–2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66–5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30–3.84, p = 0.004).
Conclusion
This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.
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Change history
09 August 2022
A Correction to this paper has been published: https://doi.org/10.1007/s10029-022-02656-0
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Acknowledgements
Laboratório de Farmacologia Clínica da Faculdade de Medicina da Universidade de Lisboa. We thank our expert advisory panel (A de Beaux, E Guerreiro, F Ferreira, F Muysoms, H Friis-Andersen, M Rosen, N Henriksen, S Morales-Conde, T Bisgaard, T Pinkney, A Rocha, J Fonseca) for the expertise and advice developing the study protocol.
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PT Surg (Portuguese Collaborative Research Group). Predictors of low quality of life after open inguinal hernia repair using the EuraHS-QoL score: prospective multicentric cohort study across 33 hospitals. Hernia 26, 225–232 (2022). https://doi.org/10.1007/s10029-021-02498-2
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DOI: https://doi.org/10.1007/s10029-021-02498-2