Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Marco Ceresoli; Ionut Negoi; Monica Zese; Savino Occhionorelli; Francesca Gubbiotti; Sergei Shlyapnikov; Christian Galatioto; Massimo Chiarugi; Zaza Demetrashvili; Daniele Dondossola; Orestis Ioannidis; Giuseppe Novelli; Mirco Nacoti; Desmond Khor; Kenji Inaba; Demetrios Demetriades; Torsten Kaussen; Asri Che Jusoh; Wagih Ghan-Nam; Boris Sakakushev; Ohad Guetta; Agron Dogjani; Stefano Costa; Sandeep Singh; Dimitrios Damaskos; Arda Isik; Kuo Ching Yuan; Francesco Trotta; Stefano Rausei; Aleix Martinez-Perez; Giovanni Bellanova; Vinicius Cordeiro Fonseca; Fernando Hernández; Athanasios Marinis; Wellington Fernandes; Martha Quiodettis; Miklosh Bala; Andras Vereczkei; Rafael Curado; Gustavo Pereira Fraga; Bruno M. Pereira; Mahir Gachabayov; Guillermo Perez Chagerben; Miguel Leon Arel-Lano; Sefa Ozyazici; Gianluca Costa; Tugan Tezcaner; Matteo Porta; Yousheng Li; Faruk Karateke; Dimitrios Manatakis; Federico Mariani; Federic Lora; Ivan Sahderov; Boyko Atanasov; Sergio Zegarra; Luca Fattori; Alice Nigro; Andrew Kirkpatrick; Anton Parfenov; Giulia Montori; Paolo Dionigi; Michael Sugrue; Vincent Dubuisson; Joel Noutakdie Tochie; Rao Ivatury

doi:10.1007/s00268-019-05209-2

Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Marco Ceresoli
, Ionut Negoi
, Monica Zese
, Savino Occhionorelli
, Francesca Gubbiotti
, Sergei Shlyapnikov
, Christian Galatioto
, Massimo Chiarugi
, Zaza Demetrashvili
, Daniele Dondossola
, Orestis Ioannidis
, Giuseppe Novelli
, Mirco Nacoti
, Desmond Khor
, Kenji Inaba
, Demetrios Demetriades
, Torsten Kaussen
, Asri Che Jusoh
, Wagih Ghan-Nam
, Boris Sakakushev

Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arel-Lano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Alice Nigro, Andrew Kirkpatrick, Anton Parfenov, Giulia Montori, Paolo Dionigi, Michael Sugrue, Vincent Dubuisson, Joel Noutakdie Tochie, Rao Ivatury

University of Milano-Bicocca
ASST Monza
Emergency Surgery Hospital
Azienda Ospedaliera Universitaria di Ferrara
Science Research of Emergency Care N. A
AziendaOspedaliero-Universitaria Pisana
Kipshidze Central Universtity Hospital
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Aristotle University of Thessaloniki
Infermi Hospital
ASST Papa Giovanni Hospital Bergamo
Uniformed Services University Health Sciences
Leibniz University Hannover
Khuala Krai Hospital
Mansoura Faculty of Medicine
Medical University of Plovdiv
Soroka Medical Centre
University Hospital of Trauma
Oxford University Hospitals NHS Foundation Trust
John Radcliffe Hospital
Erzincan University Faculty of Medicine Mengucek Gazi Training Research Hospital Erzincan
Chang Gung Memorial Hospital
UO Chirurgia Generale - Ospedale Maggiore Di Cremona
University of Insubria
Hospital Clinico Universitario de Valencia
SS. Annunziata Hospital
Hospital Santa Virgínia
Hospital Central Militar, Mexico City
Tzaneio General Hospital of Piraeus
Hospital Regional de Sao Jose
Hospital Santo Tomás
Hadassah Hebrew University Medical Center
University of Pécs Medical School
University of Campinas
Vladimir City Emergency Hospital
University Hospital Ecuador
La Paz University Hospital
Department of Surgery Adana
Sant’Andrea University Hospital
University of Baskent
IRCCS-Policlinico San Donato
Shanghai Jiao Tong University School of Medicine
Department of Surgery AthensNaval Veterans Hospital
General Surgery Santa Maria alle Scotte Universitary Hospital Siena
General Surgery Città della Salute e della scienza
Krasnoyarsk Regional Vascular Centre
UMHAT ‘‘Eurohospital’’ Plovdiv
General Surgery Hospital Almenara
Regional Trauma Services Foothills Medical Centre
St. Petersburg
IRCCS Policlinico San Matteo
Letterkenny University Hospital
Bordeaux University Hospital
General Surgery Saint Jean de Malte Hospital
Virginia Commonwealth University

Research output: Contribution to a Journal (Peer & Non Peer) › Article › peer-review

13 Citations (Scopus)

Abstract

Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m². The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.

Original language	English
Pages (from-to)	53-62
Number of pages	10
Journal	World Journal of Surgery
Volume	44
Issue number	1
DOIs	https://doi.org/10.1007/s00268-019-05209-2
Publication status	Published - 1 Jan 2020
Externally published	Yes

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10.1007/s00268-019-05209-2

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Ceresoli, M., Negoi, I., Zese, M., Occhionorelli, S., Gubbiotti, F., Shlyapnikov, S., Galatioto, C., Chiarugi, M., Demetrashvili, Z., Dondossola, D., Ioannidis, O., Novelli, G., Nacoti, M., Khor, D., Inaba, K., Demetriades, D., Kaussen, T., Jusoh, A. C., Ghan-Nam, W., ... Ivatury, R. (2020). Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen. World Journal of Surgery, 44(1), 53-62. https://doi.org/10.1007/s00268-019-05209-2

@article{f695e1d0083f47aeb1d93e964710b676,

title = "Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen",

abstract = "Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5\%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8\% vs. 53.4\%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5\% vs. 89.5\%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson{\textquoteright}s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.",

author = "Marco Ceresoli and Ionut Negoi and Monica Zese and Savino Occhionorelli and Francesca Gubbiotti and Sergei Shlyapnikov and Christian Galatioto and Massimo Chiarugi and Zaza Demetrashvili and Daniele Dondossola and Orestis Ioannidis and Giuseppe Novelli and Mirco Nacoti and Desmond Khor and Kenji Inaba and Demetrios Demetriades and Torsten Kaussen and Jusoh, \{Asri Che\} and Wagih Ghan-Nam and Boris Sakakushev and Ohad Guetta and Agron Dogjani and Stefano Costa and Sandeep Singh and Dimitrios Damaskos and Arda Isik and Yuan, \{Kuo Ching\} and Francesco Trotta and Stefano Rausei and Aleix Martinez-Perez and Giovanni Bellanova and Fonseca, \{Vinicius Cordeiro\} and Fernando Hern{\'a}ndez and Athanasios Marinis and Wellington Fernandes and Martha Quiodettis and Miklosh Bala and Andras Vereczkei and Rafael Curado and Fraga, \{Gustavo Pereira\} and Pereira, \{Bruno M.\} and Mahir Gachabayov and Chagerben, \{Guillermo Perez\} and Arel-Lano, \{Miguel Leon\} and Sefa Ozyazici and Gianluca Costa and Tugan Tezcaner and Matteo Porta and Yousheng Li and Faruk Karateke and Dimitrios Manatakis and Federico Mariani and Federic Lora and Ivan Sahderov and Boyko Atanasov and Sergio Zegarra and Luca Fattori and Alice Nigro and Andrew Kirkpatrick and Anton Parfenov and Giulia Montori and Paolo Dionigi and Michael Sugrue and Vincent Dubuisson and Tochie, \{Joel Noutakdie\} and Rao Ivatury",

note = "Publisher Copyright: {\textcopyright} 2019, Soci{\'e}t{\'e} Internationale de Chirurgie.",

year = "2020",

month = jan,

day = "1",

doi = "10.1007/s00268-019-05209-2",

language = "English",

volume = "44",

pages = "53--62",

journal = "World Journal of Surgery",

issn = "0364-2313",

publisher = "John Wiley and Sons Inc",

number = "1",

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Ceresoli, M, Negoi, I, Zese, M, Occhionorelli, S, Gubbiotti, F, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, AC, Ghan-Nam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, KC, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, VC, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, GP, Pereira, BM, Gachabayov, M, Chagerben, GP, Arel-Lano, ML, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Nigro, A, Kirkpatrick, A, Parfenov, A, Montori, G, Dionigi, P, Sugrue, M, Dubuisson, V, Tochie, JN & Ivatury, R 2020, 'Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen', World Journal of Surgery, vol. 44, no. 1, pp. 53-62. https://doi.org/10.1007/s00268-019-05209-2

TY - JOUR

T1 - Open Abdomen in Obese Patients

T2 - Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

AU - Ceresoli, Marco

AU - Negoi, Ionut

AU - Zese, Monica

AU - Occhionorelli, Savino

AU - Gubbiotti, Francesca

AU - Shlyapnikov, Sergei

AU - Galatioto, Christian

AU - Chiarugi, Massimo

AU - Demetrashvili, Zaza

AU - Dondossola, Daniele

AU - Ioannidis, Orestis

AU - Novelli, Giuseppe

AU - Nacoti, Mirco

AU - Khor, Desmond

AU - Inaba, Kenji

AU - Demetriades, Demetrios

AU - Kaussen, Torsten

AU - Jusoh, Asri Che

AU - Ghan-Nam, 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

AU - Vereczkei, Andras

AU - Curado, Rafael

AU - Fraga, Gustavo Pereira

AU - Pereira, Bruno M.

AU - Gachabayov, Mahir

AU - Chagerben, Guillermo Perez

AU - Arel-Lano, Miguel Leon

AU - Ozyazici, Sefa

AU - Costa, Gianluca

AU - Tezcaner, Tugan

AU - Porta, Matteo

AU - Li, Yousheng

AU - Karateke, Faruk

AU - Manatakis, Dimitrios

AU - Mariani, Federico

AU - Lora, Federic

AU - Sahderov, Ivan

AU - Atanasov, Boyko

AU - Zegarra, Sergio

AU - Fattori, Luca

AU - Nigro, Alice

AU - Kirkpatrick, Andrew

AU - Parfenov, Anton

AU - Montori, Giulia

AU - Dionigi, Paolo

AU - Sugrue, Michael

AU - Dubuisson, Vincent

AU - Tochie, Joel Noutakdie

AU - Ivatury, Rao

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.

AB - Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.

UR - https://www.scopus.com/pages/publications/85074529488

U2 - 10.1007/s00268-019-05209-2

DO - 10.1007/s00268-019-05209-2

M3 - Article

C2 - 31602518

AN - SCOPUS:85074529488

SN - 0364-2313

VL - 44

SP - 53

EP - 62

JO - World Journal of Surgery

JF - World Journal of Surgery

IS - 1

ER -

Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

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