To evaluate the clinical characteristics, postoperative outcomes, and factors associated with Clavien-Dindo grade ≥II complications in nonagenarians undergoing elective inguinal hernia repair. Preoperative, intraoperative, and postoperative data of nonagenarians who underwent elective inguinal hernia repair were collected. The primary outcome was Clavien-Dindo grade ≥II complications. Univariable logistic regression was used to identify associated factors.

We included patients aged 90 years or older who underwent elective inguinal hernia repair at Huadong Hospital, Fudan University, between 2013 and 2025. Patients were excluded if they underwent emergency surgery for incarcerated or strangulated hernia. Patients were also excluded if incomplete data, or valid follow-up information was unavailable.

Patient data were collected from inpatient medical records, anesthesia records, nursing records, and follow-up records. Preoperative variables included age, sex, body mass index, functional status, American Society of Anesthesiologists class, comorbidities, and hernia-related characteristics. Intraoperative variables included anesthesia type, operative time, surgical approach, procedure type, mesh use, concomitant procedures, drain placement, and urinary catheterization. Postoperative variables included length of hospital stay, postoperative intensive care unit admission, postoperative complications, 30-day readmission, 30-day reoperation, in-hospital mortality, 30-day mortality, recurrence, chronic pain, reoperation for recurrence, and all-cause mortality during follow-up.

Inclusion Criteria: patients aged 90 years or older who underwent elective inguinal hernia repair -

Exclusion Criteria: Patients underwent emergency surgery for incarcerated or strangulated hernia. Patients were also excluded if incomplete data, or valid follow-up information was unavailable.

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Patients aged 90 years or older who underwent elective inguinal hernia repair