Factors Influencing Loss to Follow-up after Elective Inguinal Herniorrhaphy
Panuwat Lertsithichai MD, MSc*, Suragit Pornchai MD*
Affiliation : * Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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, tissue-
based 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.
Keywords : Inguinal herniorrhaphy, Loss to follow-up, Risk factors, Recurrence
