Popis: |
BACKGROUND: The utility of preoperative computed tomography (CT) for urgent abdominal wall hernia repair is unclear. This study tests the hypothesis that there is no difference in patient outcomes for acutely incarcerated ventral or inguinal hernias diagnosed by preoperative CT versus clinical assessment alone. METHODS: This retrospective cohort analysis included 270 adult patients undergoing urgent repair of ventral or inguinal hernia. Demographics, risk factors for complications, operative management strategies, and 1-year outcomes were compared between patients with (N=179) versus without (N=91) preoperative CT. RESULTS: Among 179 preoperative CT scans, 15 (8.4%) were ordered by surgeons and all others were ordered by referring providers. The CT and no CT groups had similar age (58 vs. 58 years, P=.77), body mass index (30.7 vs. 30.6 kg/m(2), P=.30), American Society of Anesthesiologists class (3.0 vs. 3.0, P=.39), incidence of the systemic inflammatory response syndrome (19.0% vs. 20.9%, P=.75), and incidence of recurrent hernia (16.8% vs. 19.8%, P=.61). The interval between admission and incision was longer in the CT group (11.2 hours vs. 6.6 hours, P |