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

The IROA study group

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalWorld Journal of Surgery
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Abdomen
Fascia
Fistula
Length of Stay
Mortality
Hospital Mortality
Therapeutics
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Open Abdomen in Obese Patients : Pay Attention! New Evidences from IROA, the International Register of Open Abdomen. / The IROA study group.

In: World Journal of Surgery, 01.01.2019.

Research output: Contribution to journalArticle

@article{a312fa9fe6804e03a65980db66a8761e,
title = "Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen",
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.",
author = "{The IROA study group} and Marco Ceresoli and Francesco Salvetti and Yoram Kluger and Marco Braga and Jacopo Vigan{\`o} and Paola Fugazzola and Massimo Sartelli and Luca Ansaloni and Fausto Catena and Federico Coccolini and Ionut Negoi and Monica Zese and Savino Occhionorelli and Francesca Gubbiotti and Sergei Shlyapnikov and Christian Galatioto and Massimo Chiarugi and Zaza Demetrashvili and Daniele Dondossola and Orestis Ioannidis and Giuseppe Novelli and Mirco Nacoti and Desmond Khor and Kenji Inaba and Demetrios Demetriades and Torsten Kaussen and Jusoh, {Asri Che} and Wagih Ghannam and Boris Sakakushev and Ohad Guetta and Agron Dogjani and Stefano Costa and Sandeep Singh and Dimitrios Damaskos and Arda Isik and Yuan, {Kuo Ching} and Francesco Trotta and Stefano Rausei and Aleix Martinez-Perez and Giovanni Bellanova and Fonseca, {Vinicius Cordeiro} and Fernando Hern{\'a}ndez and Athanasios Marinis and Wellington Fernandes and Martha Quiodettis and Miklosh Bala and Andras Vereczkei and Rafael Curado and Fraga, {Gustavo Pereira} and Paolo Dionigi",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00268-019-05209-2",
language = "English",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",

}

TY - JOUR

T1 - Open Abdomen in Obese Patients

T2 - Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

AU - The IROA study group

AU - Ceresoli, Marco

AU - Salvetti, Francesco

AU - Kluger, Yoram

AU - Braga, Marco

AU - Viganò, Jacopo

AU - Fugazzola, Paola

AU - Sartelli, Massimo

AU - Ansaloni, Luca

AU - Catena, Fausto

AU - Coccolini, Federico

AU - Negoi, Ionut

AU - Zese, Monica

AU - Occhionorelli, Savino

AU - Gubbiotti, Francesca

AU - Shlyapnikov, Sergei

AU - Galatioto, Christian

AU - Chiarugi, Massimo

AU - Demetrashvili, Zaza

AU - Dondossola, Daniele

AU - Ioannidis, Orestis

AU - Novelli, Giuseppe

AU - Nacoti, Mirco

AU - Khor, Desmond

AU - Inaba, Kenji

AU - Demetriades, Demetrios

AU - Kaussen, Torsten

AU - Jusoh, Asri Che

AU - Ghannam, Wagih

AU - Sakakushev, Boris

AU - Guetta, Ohad

AU - Dogjani, Agron

AU - Costa, Stefano

AU - Singh, Sandeep

AU - Damaskos, Dimitrios

AU - Isik, Arda

AU - Yuan, Kuo Ching

AU - Trotta, Francesco

AU - Rausei, Stefano

AU - Martinez-Perez, Aleix

AU - Bellanova, Giovanni

AU - Fonseca, Vinicius Cordeiro

AU - Hernández, Fernando

AU - Marinis, Athanasios

AU - Fernandes, Wellington

AU - Quiodettis, Martha

AU - Bala, Miklosh

AU - Vereczkei, Andras

AU - Curado, Rafael

AU - Fraga, Gustavo Pereira

AU - Dionigi, Paolo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85074529488&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074529488&partnerID=8YFLogxK

U2 - 10.1007/s00268-019-05209-2

DO - 10.1007/s00268-019-05209-2

M3 - Article

AN - SCOPUS:85074529488

JO - World Journal of Surgery

JF - World Journal of Surgery

SN - 0364-2313

ER -