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ACUTE ABDOMEN IN INTENSIVE CARE UNIT: ETIOLOGY, COMORBIDITY AND SEVERITY OF 1,523 PATIENTS
Geraldo Fernandes de Almeida Filho1, Pedro Paulo Costa E Silva1, Murilo Tavares Valverde Filho1
1Escola Bahiana de Medicina e Saúde Pública, Medical School - Salvador (BA), Brazil.
Background:
Clinical features and outcomes of patients admitted to the intensive care unit due to acute abdomen are important to be investigated.
Aims:
To evaluate the outcomes of critically ill subjects with acute abdomen according to etiology, comorbidity and severity.
Methods:
Outcomes of 1,523 patients (878 women, mean age 66±18 years) consecutively admitted to a specialized gastrointestinal intensive care unit with different causes of acute abdomen from January 2012 to December 2019, were retrospectively evaluated according to etiology, comorbidity and severity.
Results:
The most common causes of acute abdomen were obstructive and inflammatory, particularly large bowel obstruction (27%), small bowel obstruction (18%) and acute pancreatitis (17%). Overall mortality was 13%. Surgery was required in 34% of patients. Median length of stay in the hospital was 9 [1-101] days. On univariate analysis mortality was significantly associated with age, APACHE II, Charlson comorbidity index, requirement for surgery and malignancy (p<0.0001), but only APACHE II, Charlson comorbidity index and surgical interventional remained significant on multivariate analysis.
Conclusions:
Critically ill patients admitted to the intensive care unit with acute abdomen constitute a heterogeneous group of subjects with different prognosis. Mortality is more related to the severity of the disease, comorbidity and need for surgery than to the etiology of the acute abdomen.
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