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01-01-2020 | Abdominal Compartment Syndrome | Original Scientific Report

Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Authors: Marco Ceresoli, Francesco Salvetti, Yoram Kluger, Marco Braga, Jacopo Viganò, Paola Fugazzola, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Federico Coccolini, The IROA study group

Published in: World Journal of Surgery | Issue 1/2020

Abstract

Background

Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen.

Methods

This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m². The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay.

Results

A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001).

Conclusions

Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate.

Trial registration number

ClinicalTrials.gov, Identifier: NCT02382770.

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Title: Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen
Authors: Marco Ceresoli
Francesco Salvetti
Yoram Kluger
Marco Braga
Jacopo Viganò
Paola Fugazzola
Massimo Sartelli
Luca Ansaloni
Fausto Catena
Federico Coccolini
The IROA study group
Publication date: 01-01-2020
Publisher: Springer International Publishing
Keyword: Abdominal Compartment Syndrome
Published in: World Journal of Surgery / Issue 1/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05209-2

At a glance: The STEP trials

Springer Medicine

Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Abstract

Background

Methods

Results

Conclusions

Trial registration number

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration number

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