Table 4. Association of patient demographics, comorbid diseases and symptoms with urgent or emergent paraesophageal hernia repair.
| Nonelective operation | |||||||
|---|---|---|---|---|---|---|---|
|
|
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| Patient Demographics: (n, [%]) | Overall n=980 |
Elective n=781 |
Nonelective n=199 |
p-value | Adjusted ORd | 95% CI | |
| Sex | Female | 733 (75) | 595 (81) | 138 (19) | 0.055 | ||
| Male | 247 (25) | 186 (75) | 61 (25) | ||||
|
| |||||||
| Age group at operation | <50 | 60 (6) | 51 (85) | 9 (15) | <0.001 | ref | ref |
| 50-59 | 148 (15) | 130 (88) | 18 (12) | 0.80 | (0.33, 1.96) | ||
| 60-69 | 261 (27) | 234 (90) | 27 (10) | 0.61 | (0.26, 1.42) | ||
| 70-70 | 319 (33) | 265 (83) | 55 (17) | 0.93 | (0.42, 2.09) | ||
| 80+ | 192 (20) | 102 (53) | 90 (47) | 2.66 | (1.16, 6.10) | ||
|
| |||||||
| Body MassIndex by WHO classificationa | Underweight | 16 (2) | 9 (56) | 7 (44) | <0.001 | ref | ref |
| Ideal | 185 (19) | 126 (68) | 59 (32) | 0.50 | (0.13, 1.73) | ||
| Overweight | 356 (37) | 295 (83) | 61 (17) | 0.35 | (0.10, 1.12) | ||
| Obese | 258 (27) | 220 (85) | 38 (15) | 0.36 | (0.10, 1.27) | ||
| Severely obese | 149 (15) | 127 (85) | 22 (15) | 0.42 | (0.12, 1.54) | ||
|
| |||||||
| Preoperative Hernia Size (%)b | 30-49% | 174 (18) | 157 (90) | 17 (10) | <0.001 | ref | ref |
| 50-74% | 354 (36) | 300 (85) | 54 (15) | 1.40 | (0.74, 2.60) | ||
| 75-99% | 212 (22) | 159 (75) | 53 (25) | 2.60 | (1.25, 4.88) | ||
| Intrathoracic Stomach | 240 (24) | 165 (69) | 75 (31) | 3.00 | (1.59, 5.58) | ||
|
| |||||||
| History of Pretreatment Charlson-defined patient comorbidity | |||||||
|
| |||||||
| Myocardial infarction or revascularization | No | 833 (85) | 677 (81) | 156 (19) | 0.005 | 1.27 | (0.80, 2.02) |
| Yes | 147 (15) | 104 (71) | 43 (29) | ||||
|
| |||||||
| Congestive heart failure | No | 941 (96) | 761 (81) | 180 (19) | <0.001 | 1.84 | (0.83, 4.05) |
| Yes | 39 (4) | 20 (51) | 19 (48) | ||||
|
| |||||||
| Cerebral vascular accident or transient attack | No | 904 (92) | 737 (82) | 167 (18) | <0.001 | 1.60 | (0.87, 2.83) |
| Yes | 76 (8) | 44 (58) | 32 (42) | ||||
|
| |||||||
| Dementia | No | 937 (96) | 763 (81) | 174 (19) | <0.001 | 2.43 | (1.13, 5.22) |
| Yes | 43 (4) | 18 (42) | 25 (58) | ||||
|
| |||||||
| Pulmonary disease | No | 690 (70) | 550 (80) | 140 (20) | 1.000 | ||
| Yes | 290 (30) | 231 (80) | 59 (20) | ||||
|
| |||||||
| Connective Tissue Disorder | No | 942 (96) | 750 (80) | 192 (20) | 1.000 | ||
| Yes | 38 (4) | 31 (82) | 7 (18) | ||||
|
| |||||||
| Peptic Ulcer Disease | No | 794 (81) | 655 (82) | 139 (18) | <0.001 | 2.20 | (1.50, 3.30) |
| Yes | 186 (19) | 126 (68) | 60 (32) | ||||
|
| |||||||
| Diabetes requiring medical therapy | No | 909 (93) | 728 (80) | 181 (20) | 0.284 | ||
| Yes | 71 (7) | 53 (75) | 18 (25) | ||||
|
| |||||||
| Malignancy in the past 5 years | No | 924 (94) | 740 (80) | 184 (20) | 0.231 | ||
| Yes | 56 (6) | 41 (73) | 15 (27) | ||||
|
| |||||||
| Rare CCI variablesc | No | 939 (96) | 753 (80) | 186 (20) | 0.074 | ||
| Yes | 41 (4) | 28 (68) | 13 (32) | ||||
|
| |||||||
| Preoperative Symptoms | |||||||
|
| |||||||
| Respiratory Symptoms | No | 232 (34) | 164 (71) | 68 (29) | <0.001 | ||
| Yes | 450 (66) | 373 (83) | 77 (17) | ||||
|
| |||||||
| Chest and/or Abdominal pain | No | 273 (32) | 236 (86) | 37 (14) | 0.001 | ||
| Yes | 589 (68) | 449 (76) | 140 (24) | ||||
|
| |||||||
| Heartburn | No | 335 (35) | 226 (67) | 109 (33) | <0.001 | ||
| Yes | 626 (65) | 545 (87) | 81 (13) | ||||
|
| |||||||
| Dysphagia | No | 533 (55) | 418 (78) | 115 (22) | 0.122 | ||
| Yes | 431 (45) | 356 (83) | 75 (17) | ||||
|
| |||||||
| Regurgitation | No | 377 (39) | 316 (84) | 61 (16) | 0.014 | ||
| Yes | 590 (61) | 456 (77) | 134 (23) | ||||
|
| |||||||
| Bloating | No | 619 (66) | 483 (78) | 136 (22) | 0.016 | ||
| Yes | 325 (34) | 275 (85) | 50 (15) | ||||
Underweight BMI <18.5; Ideal BMI 18.5 up to 25; Overweight BMI 25 up to 30; Obese BMI 30 up to 35; Severely Obese BMI 35 or greater
Percent of stomach within the mediastinum by barium esophagram, preoperative endoscopy or by intraoperative description
Rare CCI variables (<3% of cohort) include peripheral vascular disease, renal disease, liver disease, diabetes mellitus with organ damage, hemiplegia or paraplegia, lymphoma, leukemia, metastatic cancer and acquired immunodeficiency syndrome
Each adjusted for the other variables in the model (age group, BMI, size of hernia, myocardial infarction, congestive heart failure, cerebral vascular accident or transient attack, dementia, peptic ulcer disease)
BMI - body mass index (kg/m2); WHO - World Health Organization; CCI - Charlson Comorbidity Index