Routine open abdomen treatment compared with on-demand open abdomen or direct closure following open repair of ruptured abdominal aortic aneurysms: A propensity score–matched study
| Autor: | Joakim Nordanstig, Urban Wingren, Göran Bergström, Marcus Langenskiöld, Kristian Smidfelt |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Abdominal compartment syndrome 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine abdominal aortic aneurysm On demand Ruptured abdominal aortic aneurysm medicine In patient 030212 general & internal medicine Major complication Open abdomen lcsh:R5-920 business.industry General Medicine medicine.disease mortality Abdominal aortic aneurysm Surgery open repair abdominal compartment syndrome closure vacuum assisted Propensity score matching Open repair Original Article lcsh:Medicine (General) business |
| Zdroj: | SAGE Open Medicine SAGE Open Medicine, Vol 7 (2019) |
| ISSN: | 2050-3121 |
| Popis: | Objective: To investigate whether a strategy of treatment with a primarily open abdomen improves outcome in terms of mortality and major complications in patients treated with open repair for a ruptured abdominal aortic aneurysm compared to a strategy of primary closure of the abdomen. Design: Retrospective cohort study. Methods: Patients treated with a primarily open abdomen at a centre where this strategy was routine in most ruptured abdominal aortic aneurysm patients were compared to a propensity score–matched control group of patients who had the abdomen closed at the end of the primary operation in a majority of the cases. Results: In total, 79 patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm at Sahlgrenska University Hospital were compared to a propensity score–matched control group of 148 patients. The abdomen was closed at the end of the procedure in 108 (73%) of the control patients. There was no difference in 30-day mortality between patients treated with a primarily open abdomen at Sahlgrenska University Hospital and the controls, 21 (26.6%) versus 49 (33.1%), p = 0.37. The adjusted odds ratio for mortality at 30 days was 0.66 (95% confidence interval: 0.35–1.25) in patients treated with a primarily open abdomen at Sahlgrenska University Hospital compared to the controls. No difference was observed between the groups regarding 90-day mortality, postoperative renal failure requiring renal replacement therapy, postoperative intestinal ischaemia necessitating bowel resection or postoperative bleeding requiring reoperation. Conclusions: The study did not show any survival advantage or difference in major complications between patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm and propensity-matched controls where the abdomen was primarily closed in a majority of the cases. |
| Databáze: | OpenAIRE |
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