Open AccessAssociation Between Thoracic Aortic Disease and Inguinal Hernia
Author(s) -
Olsson Christian,
Eriksson Per,
FrancoCereceda Anders
Publication year - 2014
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.114.001040
Subject(s) - medicine , odds ratio , inguinal hernia , confidence interval , propensity score matching , hernia , thoracic aortic aneurysm , abdominal aortic aneurysm , population , aortic aneurysm , surgery , aneurysm , aorta , environmental health
Background The study hypothesis was that thoracic aortic disease ( TAD ) is associated with a higher‐than‐expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm ( AAA ) and hernia. Unlike AAA , TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population‐based screening programs for TAD . Therefore, conditions associated with TAD , such as inguinal hernia, are of particular clinical relevance. Methods and Results The prevalence of inguinal hernia in subjects with TAD was determined from nation‐wide register data and compared to a non‐ TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non‐ TAD , P =0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non‐ TAD , P <0.001. Variables independently associated with hernia in multivariable analysis were male sex (odds ratio [ OR ] with 95% confidence interval [95% CI ]) 3.4 (2.1 to 5.4), P <0.001; increased age, OR 1.02/year (1.004 to 1.04), P =0.014; and TAD , OR 1.8 (1.1 to 2.8), P =0.015. Conclusions The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non‐ TAD . TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study.