Besch BM, et al. - In this cross-sectional study, researchers assessed the link between patients with exfoliation syndrome (XFS) and patients with inguinal hernias (IH) in Utah, possibly differing between direct or indirect hernia. They observed an increased risk of XFS in relation to IH in this Utah population.

Methods

• Researchers performed this cross-sectional study in a large health care system of Utah hospitals and clinics.
• They used conditional logistic regression odds ratios to estimate risk of XFS in patients with IH overall and by subtype (direct or indirect) vs controls.
• They classified IH subtypes that were not prespecified by using codes specific to direct and indirect IH as well as by reviewing additional medical records for 186 procedures.
• For calculating 95% confidence intervals, they used bootstrap resampling with jackknife estimation.
• The model was adjusted for body mass index and tobacco use and accounted for matching on sex and age.
• They identified 2,594 patients 40 years or older on January 1, 1996, with surgical IH repair and 12,966 random control patients with no IH history matched 5:1 on sex and birth year, by using medical records from 1996 to 2015 for a population-based sample.
• Data analysis was carried out between September 10, 2017, and October 23, 2017.
• The main outcomes and measures included exfoliation syndrome outcome defined by diagnosis codes for XFS or exfoliation glaucoma from 1996 to 2015.

Results

• The study population comprised mainly white subjects (2,532 of 2,594 patients, [96.1%]; 12,454 of 12,966 control individuals [97.6%]) and non-Hispanic (2,396 of 2,594 patients [92.4%]); 250 participants were women (9.6%).
• A diagnosis of XFS was made in 22 patients with IH and 43 control individuals, respectively.
• A 2.3-fold risk for an XFS diagnosis was reported for patients with IH vs control individuals (95% CI, 1.4-3.5; P = .03), and XFS risk with indirect IH appeared especially pronounced.