Open abdomen and age; results from IROA (International Register of Open Abdomen)
Federico Coccolini1, Daniele Perrina2, Marco Ceresoli3
1General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy; General Surgery, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
Insights
Open abdomen (OA) treatment is feasible across all ages, but advanced age significantly increases complication and mortality risks. This study analyzed OA outcomes in 760 patients across four age groups.
Area of Science:
- Surgical outcomes research
- Geriatric medicine
- Critical care medicine
Background:
- Limited data exist on the epidemiology and outcomes of patients undergoing open abdomen (OA) treatment, particularly concerning age-related differences.
- Understanding these variations is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To investigate the impact of age on the outcomes of patients treated with open abdomen (OA).
- To analyze complication rates and mortality across different age demographics undergoing OA.
Main Methods:
- A prospective, observational cohort study involving 760 patients treated with OA.
- Patients were stratified into four age groups: 16-40, 41-60, 61-80, and over 80 years.
- Data collected included indications for OA, duration, closure rates, complications, and mortality at 1 month and 1 year.
Main Results:
- The most frequent indication for OA was peritonitis (50.9%).
- Overall mortality was 41.2%, with a significant increase in older age groups (25.6% in 16-40 y.o. vs. 67.1% in >80 y.o.).
- Complication rates (84.8%) and mortality showed significant differences across age groups (p < 0.001).
Conclusions:
- Open abdomen treatment is a viable option for patients of all ages.
- Age is a significant factor influencing the outcomes of OA treatment, with advanced age correlating with higher complication and mortality rates.
- The distribution of diseases requiring OA treatment varies across different age groups.
Introduction:
No definitive data exist regarding epidemiology and outcomes of patients treated with open abdomen (OA) linked to age.
Methods:
This is a prospective, observational, cohort study that includes patients treated with OA. Patients were divided into 4 age groups: group 1: 16-40 y.o.; group 2: 41-60 y.o.; group 3:61-80 y.o.; group 4:> 80 y.o.
Results:
760 patients were enrolled. Average age was 60 ± 18aa; 57.2% were males. Most frequent indication was peritonitis (50.9%). Mean open duration of open abdomen was8±18 days. Definitive closure was reached in 81.1% of patients. Complications were recorded in 84.8% of patients with significant differences between groups (p = 0.001). Overall mortality was41.2% with significant differences between groups (p < 0.001) (group 1 25.6%, group 2 36.1%, group 3 44.5%, group 4 67.1%) 1 month follow-up mortality post-OA was 9.2% and 1 year follow-up mortality was 11.6%; CONCLUSIONS: Open abdomen treatment is feasible at every age. Diseases requiring treatment with OA are differently distributed in relation to the different age groups. Advanced age has negative effect on complications and mortality rate.
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