{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:25:25Z","timestamp":1774877125160,"version":"3.50.1"},"reference-count":15,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background\/Objectives: Older adults frequently present with emergency ventral hernias, a situation that carries significant physiological risks and often requires challenging clinical decisions. Despite the prevalence of these cases, there is a lack of robust evidence to inform emergency care in this demographic, as most existing research centres on short-term mortality rates and operative variables. Key aspects such as the impact of frailty and the course of recovery following surgery are insufficiently addressed in the literature. This study aimed to describe management strategies, frailty burden and postoperative outcomes in older adults presenting with emergency ventral hernias. Methods: This study retrospectively examined patients aged 65 and older who were admitted to a UK tertiary centre with emergency ventral hernias from February 2016 to July 2024. Data, including patient demographics, comorbid conditions, frailty status (as measured by the Clinical Frailty Scale), management approach, healthcare resource use, and clinical outcomes, were analysed descriptively. Additionally, a structured literature review was conducted in accordance with PRISMA guidelines to identify research on emergency ventral hernia treatment outcomes in adults aged 60 years and older. Results: A total of 67 patients met the inclusion criteria for the cohort. High rates of frailty and multiple coexisting health conditions were observed. While surgical intervention was the predominant management strategy, a subset of patients received conservative or palliative care. Greater degrees of frailty correlated with longer hospital stays and an increased need for critical care, even though six-month mortality remained comparatively low. Traditional risk assessment tools tended to overpredict mortality risk and failed to reflect the true postoperative burden or the recovery process. The systematic review yielded 7 studies, most of which documented mortality and complication rates, but few addressed frailty or provided detailed postoperative recovery data. Conclusions: The management of emergency ventral hernias in older adults is highly variable, with a significant postoperative impact that extends beyond mortality statistics. Assessing frailty appears to provide additional information that may support clinical decision-making and help anticipate recovery after surgery. Integrating frailty evaluation into emergency hernia care could enhance multidisciplinary collaboration and help ensure that treatment plans are better tailored to patient vulnerability and individual care goals.<\/jats:p>","DOI":"10.3390\/geriatrics11020036","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T12:11:44Z","timestamp":1774872704000},"page":"36","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency Ventral Hernia Management in Older Adults: A Retrospective Cohort Study and Structured Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Ivan","family":"Tomasi","sequence":"first","affiliation":[{"name":"Department of General Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"},{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eimante","family":"Raupelyte","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7793-0121","authenticated-orcid":false,"given":"Antonia Elizabeth","family":"Loizou","sequence":"additional","affiliation":[{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Wang Yihui","sequence":"additional","affiliation":[{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7190-9728","authenticated-orcid":false,"given":"Lilian Chioma Ujunwa","family":"Nwosu","sequence":"additional","affiliation":[{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3308-4204","authenticated-orcid":false,"given":"Sneha","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8246-6555","authenticated-orcid":false,"given":"Mariia","family":"Druziagina","sequence":"additional","affiliation":[{"name":"School of Medicine, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth Wing Ngai","family":"Law","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magda","family":"Sbai","sequence":"additional","affiliation":[{"name":"Perioperative Medicine for Older People Undergoing Surgery (POPS) Service, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/bjs.1800720127","article-title":"Incisional hernia: A 10 year prospective study of incidence and attitudes","volume":"72","author":"Mudge","year":"1985","journal-title":"Br. J. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s10029-011-0863-4","article-title":"Prevalence of adult paraumbilical hernia. Assessment by high-resolution sonography: A hospital-based study","volume":"16","author":"Bedewi","year":"2012","journal-title":"Hernia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.jss.2018.07.034","article-title":"Emergent laparoscopic ventral hernia repairs","volume":"232","author":"Kao","year":"2018","journal-title":"J. Surg. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1749-7922-8-50","article-title":"WSES guidelines for emergency repair of complicated abdominal wall hernias","volume":"8","author":"Sartelli","year":"2013","journal-title":"World J. Emerg. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1007\/s00464-013-3313-9","article-title":"Ventral hernia repairs in the oldest-old: High-risk regardless of approach","volume":"28","author":"Spaniolas","year":"2014","journal-title":"Surg. Endosc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s10029-020-02293-5","article-title":"Emergency surgery of the abdominal wall hernias: Risk factors that increase morbidity and mortality\u2014A single-center experience","volume":"25","author":"Surek","year":"2021","journal-title":"Hernia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1177\/00031348221101577","article-title":"Complicated Abdominal Wall Hernias in the Elderly: Time Is Life and Comorbidities Matter","volume":"89","author":"Gebran","year":"2023","journal-title":"Am. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Patel, S., Smiley, A., Feingold, C., Khandehroo, B., Kajmolli, A., and Latifi, R. (2022). Chances of mortality are 3.5-times greater in elderly patients with umbilical hernia than in adult patients: An analysis of 21,242 patients. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191610402"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jamcollsurg.2020.08.735","article-title":"Improved understanding of acute incisional hernia incarceration: Implications for addressing the excess mortality of emergent repair","volume":"231","author":"Huckaby","year":"2020","journal-title":"J. Am. Coll. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"389","DOI":"10.5505\/tjtes.2012.48827","article-title":"Incarcerated abdominal wall hernia surgery: Relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)","volume":"18","author":"Ozkan","year":"2012","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_11","first-page":"28","article-title":"Preoperative Risk Stratification and Outcomes in Hernia Surgery in Elderly Patients in Tribal Area of Western Maharashtra","volume":"14","author":"Thalpati","year":"2025","journal-title":"Int. J. Life Sci. Biotechnol. Pharma Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"zrae039","DOI":"10.1093\/bjsopen\/zrae039","article-title":"Impact of clinical frailty on surgical and non-surgical complications after major emergency abdominal surgery","volume":"8","author":"Hauge","year":"2024","journal-title":"BJS Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1007\/s00268-023-07140-z","article-title":"Frailty assessment can enhance current risk prediction tools in emergency laparotomy: A retrospective cohort study","volume":"47","author":"Isand","year":"2023","journal-title":"World J. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. 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