Factors influencing loss to follow-up after elective inguinal herniorrhaphy

Abstract

Objective: To identify risk factors associated with losses to follow-up after inguinal herniorrhaphy and to examine whether these factors are associated with higher risks for recurrence according to the literature. Material and Method: Records of inguinal hernia patients who underwent elective inguinal herniorrhaphy between January 1998 and November 2006 were reviewed. Factors potentially associated with loss to follow-up included demographic variables, type of hernia, predisposing factors, type of anesthesia, surgeon experience, type of repair, and early operative complications. Loss to follow-up was defined as the absence of follow-up information three months after herniorrhaphy for at least two years. Results: There were 1,451 patients with 1,727 hernia operations. Of these, 981 operations (57%) were lost to follow-up. On multivariable analysis, factors associated with loss to follow-up included younger age, male gender, secondary hernia, tissuebased repair, indirect inguinal hernia, and no postoperative complications. Many of these factors were not known to be associated with increased recurrence after hernia repair. Conclusion: Hernia repairs lost to follow-up were systematically different from those not lost to follow-up, but factors related to these losses were not clearly or uniformly associated with higher risks for recurrence according to the literature.