TY - JOUR
T1 - Patients with an Open Abdomen in Asian, American and European Continents
T2 - A Comparative Analysis from the International Register of Open Abdomen (IROA)
AU - IROA study Group
AU - Sibilla, Maria Grazia
AU - Cremonini, Camilla
AU - Portinari, Mattia
AU - Carcoforo, Paolo
AU - Tartaglia, Dario
AU - Cicuttin, Enrico
AU - Musetti, Serena
AU - Strambi, Silvia
AU - Sartelli, Massimo
AU - Radica, Margherita Koleva
AU - Catena, Fausto
AU - Chiarugi, Massimo
AU - Coccolini, Federico
AU - Montori, Giulia
AU - Salvetti, Fracensco
AU - Negoi, Ionut
AU - Zese, Monica
AU - Occhionorelli, Savino
AU - Shlyapnikov, Sergei
AU - Sugrue, Michael
AU - Demetrashvili, Zaza
AU - Dondossola, Daniele
AU - Ioannidis, Orestis
AU - Novelli, Giuseppe
AU - Frattini, Cristina
AU - Nacoti, Mirco
AU - Khor, Desmond
AU - Inaba, Kenji
AU - Demetriades, Demetrios
AU - Kaussen, Torsten
AU - Jusoh, Asri Che
AU - Ghannam, Wagih
AU - Sakakushev, Boris
AU - Guetta, Ohad
AU - Dogjani, Agron
AU - Costa, Stefano
AU - Singh, Sandeep
AU - Damaskos, Dimitrios
AU - Isik, Arda
AU - Yuan, Kuo Ching
AU - Trotta, Francesco
AU - Rausei, Stefano
AU - Martinez-Perez, Aleix
AU - Bellanova, Giovanni
AU - Fonseca, Vinicius Cordeiro
AU - Hernández, Fernando
AU - Marinis, Athanasios
AU - Fernandes, Wellington
AU - Quiodettis, Martha
AU - Bala, Miklosh
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background: International register of open abdomen (IROA) enrolls patients from several centers in American, European, and Asiatic continent. The aim of our study is to compare the characteristics, management and clinical outcome of adult patients treated with OA in the three continents. Material and methods: A prospective analysis of adult patients enrolled in the international register of open abdomen (IROA). Trial registration: NCT02382770. Results: 1183 patients were enrolled from American, European and Asiatic Continent. Median age was 63 years (IQR 49–74) and was higher in the European continent (65 years, p < 0.001); 57% were male. The main indication for OA was peritonitis (50.6%) followed by trauma (15.4%) and vascular emergency (13.5%) with differences among the continents (p < 0.001). Commercial NPWT was preferred in America and Europe (77.4% and 52.3% of cases) while Barker vacuum pack (48.2%) was the preferred temporary abdominal closure technique in Asia (p < 0.001). Definitive abdominal closure was achieved in 82.3% of cases in America (fascial closure in 90.2% of cases) and in 56.4% of cases in Asia (p < 0.001). Prosthesis were mostly used in Europe (17.3%, p < 0.001). The overall entero-atmospheric fistula rate 2.5%. Median open abdomen duration was 4 days (IQR 2–7). The overall intensive care unit and hospital length-of-stay were, respectively, 8 and 11 days (no differences between continents). The overall morbidity and mortality rates for America, Europe, and Asia were, respectively, 75.8%, 75.3%, 91.8% (p = 0.001) and 31.9%, 51.6%, 56.9% (p < 0.001). Conclusion: There is no uniformity in OA management in the different continents. Heterogeneous adherence to international guidelines application is evident. Different temporary abdominal closure techniques in relation to indications led to different outcomes across the continents. Adherence to guidelines, combined with more consistent data, will ultimately allow to improving knowledge and outcome.
AB - Background: International register of open abdomen (IROA) enrolls patients from several centers in American, European, and Asiatic continent. The aim of our study is to compare the characteristics, management and clinical outcome of adult patients treated with OA in the three continents. Material and methods: A prospective analysis of adult patients enrolled in the international register of open abdomen (IROA). Trial registration: NCT02382770. Results: 1183 patients were enrolled from American, European and Asiatic Continent. Median age was 63 years (IQR 49–74) and was higher in the European continent (65 years, p < 0.001); 57% were male. The main indication for OA was peritonitis (50.6%) followed by trauma (15.4%) and vascular emergency (13.5%) with differences among the continents (p < 0.001). Commercial NPWT was preferred in America and Europe (77.4% and 52.3% of cases) while Barker vacuum pack (48.2%) was the preferred temporary abdominal closure technique in Asia (p < 0.001). Definitive abdominal closure was achieved in 82.3% of cases in America (fascial closure in 90.2% of cases) and in 56.4% of cases in Asia (p < 0.001). Prosthesis were mostly used in Europe (17.3%, p < 0.001). The overall entero-atmospheric fistula rate 2.5%. Median open abdomen duration was 4 days (IQR 2–7). The overall intensive care unit and hospital length-of-stay were, respectively, 8 and 11 days (no differences between continents). The overall morbidity and mortality rates for America, Europe, and Asia were, respectively, 75.8%, 75.3%, 91.8% (p = 0.001) and 31.9%, 51.6%, 56.9% (p < 0.001). Conclusion: There is no uniformity in OA management in the different continents. Heterogeneous adherence to international guidelines application is evident. Different temporary abdominal closure techniques in relation to indications led to different outcomes across the continents. Adherence to guidelines, combined with more consistent data, will ultimately allow to improving knowledge and outcome.
UR - http://www.scopus.com/inward/record.url?scp=85141160610&partnerID=8YFLogxK
U2 - 10.1007/s00268-022-06733-4
DO - 10.1007/s00268-022-06733-4
M3 - Article
C2 - 36326921
AN - SCOPUS:85141160610
SN - 0364-2313
VL - 47
SP - 142
EP - 151
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 1
ER -