DETERMINANTS OF MORTALITY AND DISEASE SEVERITY IN EMERGENCY VENTRAL HERNIA REPAIR: A PROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE

Abstract

Background:
Emergency ventral hernia repair carries significantly higher morbidity and mortality than
elective surgery, largely due to delayed presentation and bowel compromise. However,
prospective data identifying determinants of mortality and operative decision-making in such
settings remain limited.
Materials and Methods:
This prospective observational study included 50 patients undergoing emergency surgery for
complicated ventral hernia (2024–2026). Clinical, intraoperative, and postoperative variables
were analysed. Logistic regression identified independent predictors of mortality.
Results:
Most patients were aged 51–70 years (62%). Strangulation occurred in 38%, and bowel
resection was required in 34%. Postoperative complications occurred in 58%, with overall
mortality of 22%. All deaths occurred in patients with strangulation requiring bowel resection
and postoperative sepsis. Mortality among resection cases was 64.7%. Strangulation (OR 6.8,
p = 0.002), bowel resection (OR 9.4, p < 0.001), and age >60 years (OR 2.6, p = 0.04) were
independent predictors of mortality. Type of repair was not associated with complications (p
= 0.66).
Conclusion:
Mortality in emergency ventral hernia is primarily driven by disease severity at presentation
rather than operative technique. The progression from delayed presentation to strangulation
and bowel resection represents a critical pathway leading to adverse outcomes. Early elective
repair and timely intervention are essential to reduce mortality.