Management of the Open Abdomen in Obese Trauma Patients
| Autor: | Karen Safcsak, Matthew Johnston, Chadwick Smith, Michael L. Cheatham |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty education.field_of_study Abdominal compartment syndrome business.industry medicine.medical_treatment Population General Medicine medicine.disease Intensive care unit Surgery law.invention law Anesthesia Severity of illness medicine Injury Severity Score Simplified Acute Physiology Score education business Body mass index |
| Zdroj: | The American Surgeon. 81:1134-1137 |
| ISSN: | 1555-9823 0003-1348 |
| Popis: | Obesity incidence in the trauma population is increasing. Abdominal compartment syndrome has poor outcomes when left untreated. Surgeons may treat obese patients differently because of concern for increased morbidity and mortality. We studied the effects of body mass index (BMI) on resource utilization and outcome. An Institutional Review Board-approved retrospective review of trauma patients requiring temporary abdominal closure (TAC) was performed. Patients were stratified as follows: Group 1-BMI = 18.5 to 24.9 kg/m2, Group 2-BMI = 25 to 29.9 kg/m2, Group 3-BMI = 30 to 39.9 kg/m2, Group 4-BMI ≥ 40 kg/m2. Demographic data, illness severity as defined by Injury Severity Score, Acute Physiology and Chronic Health Evaluation Score Version II and Simplified Acute Physiology Score Version II scores, resource utilization, fascial closure rate, and survival were collected. About 380 patients required TAC. Median age of Group 1 was significantly lower than Groups 2 and 3 ( P = 0.001). Severity of illness did not differ. Group 4 had a longer intensive care unit stay compared with Groups 1 and 2 ( P = 0.005). Group 4 required mechanical ventilation longer than Group 1 ( P = 0.027). Hospital stay, fascial closure, and survival were equivalent. Obese trauma patients with TAC have a longer intensive care unit stay and more ventilator days, but there is no difference in survival or type of closure. TAC can be used safely in trauma patients with a BMI ≥ 30 kg/m2. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|