Management of Acutely Symptomatic Hernia

N/AUnknownNCT04197271

Sheffield Teaching Hospitals NHS Foundation Trust280 enrolled

Overview

Acutely symptomatic abdominal wall hernia can cause many symptoms and complications. They can be associated with levels of morbidity beyond that seen in emergency laparotomy. There is limited data to guide practice in this field. This observational cohort study will explore variation in practice around assessment, repair and outcomes of hernias treated in the emergency setting.

There are many different types of hernia, with the most common being in the groin or at the umbilicus. Hernias affect a significant proportion of the population and can vary from producing no symptoms at all, to causing a blockage to the bowel that requires urgent surgery. Hernias affect people of all ages and degrees of health, but become increasingly common with age. As our population ages and therefore becomes generally more unwell, the risks of surgery increase. Recent evidence suggests that emergency hernia repair is associated with worse outcomes than planned procedures. At present there are limited guidelines for the management of acutely symptomatic hernias and therefore practice varies between hospitals. This cohort study will capture information on patients treated in the UK for acutely symptomatic hernia, and will provide information on variation in assessment, and technical aspects of repair. It will also capture health utility data out to 90 days post discharge from hospital.

Study Type

OBSERVATIONAL

Enrollment

280

Conditions

Hernia Emergencies Surgery--Complications

Interventions

Emergency Hernia RepairPROCEDURE

Emergency repair of hernia using method selected by treating surgeon.

Conservative managementOTHER

Treatment of hernia without resort to surgery

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 18 years and over * Patients admitted directly to the emergency surgery service (via A+E or GP) * Patients referred to the emergency surgical team by another inpatient specialty * Patients with a diagnosis of an acutely symptomatic hernia made by a specialist surgical trainee (ST3+) or Consultant Surgeon * Willing to take part in the study Exclusion Criteria: * Patients under 18 years of age * Pregnant women * Patients with a symptomatic parastomal, hiatal or diaphragmatic hernia * Patients with a traumatic hernia * Unable to consent

Locations (1)

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield, South Yorkshire, United Kingdom

Outcomes

Primary Outcomes

In hospital morbidity

As defined using the comprehensive complication index

Time frame: up to 28 days after surgery

Secondary Outcomes

Mortality

Death occuring (binary)

Time frame: Measured at baseline, 30 days post discharge, and 90 days post recruitment

Hospital length of stay

Time from admission to discharge measured in days

Time frame: Within 30 days of recruitment to study

Unplanned readmission within 30 days

Unplanned readmission to hospital for any reason following treatment of hernia

Time frame: Up to 30 days of recruitment

Change in health utility

Measured using EQ-5D-5L questionnaire

Time frame: Measured at baseline, 30 days post discharge and 90-days post recruitment

Data from ClinicalTrials.gov

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