PROGNOSTIC FACTORS IN OPEN ABDOMEN CASES DUE TO NON TRAUMATİC ABDOMINAL COMPARTMENT SYNDROME AND INTRAABDOMİNAL SEPSIS: A RETROSPECTIVE CLINICAL TRIAL

Ekrem Ferlengez¹, Gamze Citlak¹, Sercan Yuksel¹, Yigit Soytas¹, Ayse Gul Ferlengez²

¹University of Health Sciences Haseki Training and Research Hospital, Department of General Surgery, 34096, Istanbul, Turkey - ²University of Health Sciences Istanbul Training and Research Hospital, Department of Anesthesiology and Reanimation, 34098, Istanbul, Turkey

Introduction: Open abdomen (OA) has been used increasingly with the emergence of negative pressure therapy (NPT). There are many publications in the literature on the management of OA and NPT. However, the number of publications examining open abdominal cases secondary to non-traumatic abdominal compartment syndrome (ACS) and intraabdominal sepsis (IAS) is rare. There are mainly two common indications for the application of NPT. First one is non-traumatic ACS and the second one is IAS. Therefore, we aimed to determine the factors affecting prognosis in open abdominal cases secondary to non-traumatic ACS and IAS.

Case presentation: All NPT patients between August 2015 and August 2019 were retrospectively analyzed at University of Health Sciences Haseki Training and Research Hospital. Patients’ data who underwent NPT after complication after elective surgery or after laparotomy with emergency admission were collected. We compared demographic data of patients, consisting of circulating blood count, serum C-reactive protein, serum albumin, comorbidity, duration of hospital stay, indication for NPT, number of recurrent NPT applications, OA techniques, transfusion requirements, fascia closure rates, complication and mortality rate.

During the study period, 101 patients were found to have had OA management in our clinic. According to NPT application indications, the patients had IAS of 82 (81.2%) and ACS 19 (18.8%). In our study, morbidity and mortality rates were 22 (21.8%) and 32 (31.7%), respectively.

Conclusion: Open abdomen is a lifesaving method when used in the right patient and at the right time. Our study has shown that age, serum albumin value, NPT application number, having ischemic or congestive heart disease and chronic obstructive pulmonary disease can be used as a prognostic factor for mortality.