Abstract text (incl. references and figure legends)
Purpose/Introduction:
Indications and results of Open abdomen (OA) in non-trauma patients are still scarce. The objective of this study is to report its indications and outcomes, and analyse prognostic factors of mortality.
Methodology:This is a single-center retrospective study of a prospectively maintained clinical data on consecutive patients who underwent OA for non-traumatic emergencies from 2008 to 2021 in our center.
We collected data about: demography, comorbidities, indications, intraoperative findings, surgical technique, complications, among others.
Univariate and multivariate analysis was performed to elucidate the
prognostic factors of mortality at 90 days. We used Chi-square test or Fisher"s exact test, in categorical variables, and Student t-test for quantitative variables.
Between-group differences were checked through Log-rank test.
Cox regression we used to explore factors associated with mortality events at 90 days.
Results:94 patients (58 men, median age 66) underwent OA for non-traumatic emergencies. OA was performed mainly for peritonitis (n=54). 52 patients (55.3%) deceased, and 25 (26.6%) presented Clavien-Dindo complications >IIIa. On multivariate analysis, 90-day mortality was significantly higher for pH<7.25 (p=0.013), BMI (p=0.008) and Charlson Comorbidity Index (CCI) (p=0.003). Score-predicted versus observed mortality rates emphasize importance of altered physiology. No significant differences in survival according to aetiology were proven. Survival benefit was mainly for peritonitis and acute pancreatitis.
Conclusion/s:OA is a controversial but safe surgical indication for selected non-trauma patients who have a high probability of morbimortality. Age, comorbidities, organ failure and altered physiology hinder better survival rates.
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