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Incidence and Mortality of Pediatric Abdominal Compartment Syndrome

Jordan Bozer1, Brandon Rodgers1, Naveen Qureshi2

  • 1The Ohio State University, College of Medicine, Columbus, Ohio.

The Journal of Surgical Research
|January 14, 2023
PubMed

Insights

Pediatric abdominal compartment syndrome (ACS) incidence and mortality remained stable from 2007-2019. Mortality was highest in neonates, and wide hospital variations suggest potential diagnostic inconsistencies in pediatric ACS care.

Area of Science:

  • Pediatric critical care medicine
  • Surgical critical care
  • Pediatric hospital epidemiology

Background:

  • Abdominal compartment syndrome (ACS) is a critical condition characterized by elevated intra-abdominal pressure leading to multiorgan dysfunction.
  • Pediatric ACS is associated with high mortality, but national incidence and mortality rates are not well-established.
  • Understanding these rates is crucial for improving care and outcomes in children.

Purpose of the Study:

  • To determine the national incidence and mortality rates of pediatric ACS.
  • To analyze trends in pediatric ACS incidence and mortality over a 13-year period (2007-2019).
  • To investigate variations in incidence and mortality across different age groups and hospitals in the United States.

Main Methods:

  • Retrospective cohort study utilizing the Pediatric Health Information Systems database (2007-2019).
  • Identification of pediatric patients (<18 years) with ACS using ICD-9 and ICD-10 codes.
  • Analysis of primary outcomes (incidence and mortality) by year, age, and hospital of admission.

Main Results:

  • A total of 2887 pediatric ACS cases were identified across 49 children's hospitals.
  • The overall incidence of pediatric ACS was 0.17%, with an overall mortality of 48.87%.
  • Mortality was significantly higher in neonates (0-30 days old) at 58.61% compared to older children. Annual incidence and mortality showed no significant change over the study period. Wide variations in hospital-specific incidence (0.04%-0.46%) and mortality (28.57%-71.43%) were observed.

Conclusions:

  • Pediatric ACS incidence and mortality rates have remained consistent between 2007 and 2019.
  • ACS continues to be a high-mortality condition in children, particularly neonates.
  • Significant inter-hospital variability in ACS incidence and mortality suggests potential disparities in recognition and diagnosis, highlighting a need for standardized care protocols.
Abstract

Keywords:
Abdominal compartment syndromeIntra-abdominal hypertensionIntra-abdominal pressurePediatric surgery

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