Besch BM, et al. - Authors ascertained the association between patients with exfoliation syndrome (XFS) and patients with inguinal hernias (IH) in Utah, possibly differing between direct or indirect hernia. Findings suggested an association of an inguinal hernia with an increased risk of XFS in this Utah population.

Methods

• Researchers conducted a 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) compared with control individuals.
• They used the codes specific to direct and indirect IH with additional medical records review of 186 procedures to classify IH subtypes that were not prespecified.
• They used bootstrap resampling with jackknife estimation to calculate 95% confidence intervals.
• Adjusting for body mass index and tobacco use, the model accounted for matching on sex and age.
• They noted that population-based sample using medical records from 1996 to 2015 that identified 2594 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.
• They analyzed the data between September 10, 2017, and October 23, 2017.
• Main outcomes and measures included exfoliation syndrome outcome defined by diagnosis codes for XFS or exfoliation glaucoma from 1996 to 2015.

Results

• As per data, participants were primarily white (2532 of 2594 patients, [96.1%]; 12,454 of 12,966 control individuals [97.6%]) and non-Hispanic (2396 of 2594 patients [92.4%]); 250 participants were women (9.6%).
• Twenty two of study participants patients with IH and 43 control individuals were diagnosed as having XFS, respectively.
• Compared with control individuals, patients with IH had a 2.3-fold risk for an XFS diagnosis (95% CI, 1.4-3.5; P=.03), and XFS risk with indirect IH appeared especially pronounced.