Abstract
Background: Little is known regarding the morbidity and mortality of the open abdomen technique in older nontrauma patients. Methods: A retrospective chart review identified cases of emergency laparotomy in which open abdomens were used. Results: Eighty-eight patients with open Acute Physiology and Chronic Health Evaluation (APACHE) abdomens were identified. An overall mortality rate of 34%, consistent with mortality predicted by APACHE IV score, was seen. Common complications included ventilator-associated pneumonia (30%) and acute renal failure (22%). A perioperative APACHE IV score of greater than 65 and an albumin level less than 2.5 g/dL were found to predict an increased likelihood of long-term assisted care placement after discharge from the acute care setting. Conclusions: The use of the open abdomen technique in older nontrauma patients carries acceptable morbidity and mortality given the acuity of disease. Focus on ventilator-associated pneumonia prevention and aggressive fluid resuscitation to avoid acute renal failure may improve outcomes. Need for long-term assisted care placement can be predicted early after admission based on the APACHE IV score or albumin level.
Original language | English (US) |
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Pages (from-to) | 588-592 |
Number of pages | 5 |
Journal | American journal of surgery |
Volume | 198 |
Issue number | 5 |
DOIs | |
State | Published - Nov 2009 |
Externally published | Yes |
Keywords
- Emergency general surgery
- Intra-abdominal catastrophe
- Open abdomen
ASJC Scopus subject areas
- Surgery