Longterm impact of abdominal decompression: a prospective comparative analysis.

Area of Science:

• Critical Care Medicine
• Surgical Outcomes Research

Background:

• Abdominal decompression is a common treatment for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS).
• Long-term effects of decompression on patient health, quality of life, and employment are not well-established.

Purpose of the Study:

• To evaluate the long-term physical and mental health, quality of life, and employment status of patients undergoing abdominal decompression.
• To compare outcomes between patients with chronic incisional hernias (OPEN) and those with primary fascial closure (CLOSED).

Main Methods:

• Prospective cohort study at a Level I trauma center.
• Patients requiring abdominal decompression >48 hours completed SF-36v2 surveys for 2 years.
• Comparison of outcomes between OPEN, CLOSED groups, and the general population.

Main Results:

• At 6 months, OPEN patients showed decreased physical/social functioning vs. general population; CLOSED patients did not.
• By 18 months, OPEN patients reported normal physical/mental health perception.
• Both OPEN and CLOSED groups had similar, reduced quality-adjusted life years (QALYs) and employment resumption rates.

Conclusions:

• Abdominal decompression does not adversely affect long-term physical or mental health perception.
• Primary fascial closure during the same admission does not improve quality of life or employment outcomes.
• Abdominal decompression is less debilitating than often anticipated.