Age and Probability of Spontaneous Umbilical Hernia Closure

A concise report on the probability of spontaneous umbilical hernia closure across ages 0 to 5 years. The figure is particularly helpful. James W. Mold, MD, MPH

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This cohort study of children younger than 6 years uses electronic health records to investigate whether a child’s age is associated with the probability of spontaneous umbilical hernia closure and to refine guidelines for surgical repair.

Author/s:

Katherine He, Dionne A Graham, Louis Vernacchio, Jonathan Hatoun, Laura Patane, Shannon L Cramm, Shawn J Rangel

Association between Age and Umbilical Hernia Repair Outcomes in Children: A Multistate Population-Based Cohort Study

Brian Desmarais — Sat, 25 Jan 2020 20:54:00 +0000

Date Added:

January 25, 2020

Journal/Publication:

The Journal of Pediatrics

Publication Date:

November 8, 2019

URL:

Association between Age and Umbilical Hernia Repair Outcomes in Children: A Multistate Population-Based Cohort Study

Type:

Clinical Research Results

DOI (1):

https://doi.org/10.1016/j.jpeds.2019.10.035

MeSH

This retrospective cohort study supports waiting until after age 4 to refer children for repair of their umbilical hernias. James W. Mold, MD, MPH

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OBJECTIVE:

To evaluate whether patient age or other sociodemographic and clinical characteristics are associated with recurrence or unplanned related hospital revisits after pediatric umbilical hernia repair.

STUDY DESIGN:

We performed a retrospective cohort study using the Healthcare Cost and Utilization Project State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases of 7 states. Pediatric umbilical hernia repairs performed at any hospital or surgery center in 2010-2014 were included. Hernia recurrences and occurrences of unplanned and related hospital revisits within 30 days were evaluated.

RESULTS:

Of 9809 included patients, 52.0% were female and 50.5% were black. The 3-year hernia recurrence rate was 0.57% (95% CI 0.42, 0.73). In multivariable analysis, the recurrence rate was higher in children <4 years of age than in children 4-10 years of age (hazard ratio [HR] 1.93, 95% CI 1.09, 3.44). Unplanned related hospital revisits within 30 days occurred in 2.5% of patients. Patient characteristics associated with the risk of an unplanned related hospital revisit included age <4 years (HR 2.17, 95% CI 1.70, 2.77) or >10 years (HR 2.11, 95% CI 1.46, 3.05), public insurance (HR 2.10, 95% CI 1.58, 2.79), asthma (HR 1.74, 95% CI 1.32, 2.29), and initial presentation to the emergency department (HR 2.46, 95% CI 1.08, 5.61).

CONCLUSIONS:

Rates of recurrence and unplanned related hospital revisits following pediatric umbilical hernia repair are higher in children younger than 4 years of age. These findings support delaying the repair of asymptomatic umbilical hernia in children until 4 years of age.

Author/s:

Halleran, D.R., Minneci, P.C., Cooper, J.N.