Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr-Jun;9(2):53-7.
doi: 10.4103/0974-2700.179452.

Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

Aisha W Shaheen  1 , Marie L Crandall  2 , Norman G Nicolson  2 , Eduardo Smith-Singares  3 , Gary J Merlotti  4 , Yash Jalundhwala  5 , Nabil M Issa  2
Affiliations

Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

Aisha W Shaheen et al. J Emerg Trauma Shock. 2016 Apr-Jun.

Abstract

Context: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality among trauma patients. Several clinical and laboratory findings have been suggested as markers for ACS, and these may point to different types of ACS and complications.

Aims: This study aims to identify the strength of association of clinical and laboratory variables with specific adverse outcomes in trauma patients with ACS.

Settings and design: A 5-year retrospective chart review was conducted at three Level I Trauma Centers in the City of Chicago, IL, USA.

Subjects and methods: A complete set of demographic, pre-, intra- and post-operative variables were collected from 28 patient charts.

Statistical analysis: Pearson's correlation coefficient was used to determine the strength of association between 29 studied variables and eight end outcomes.

Results: Thirty-day mortality was associated strongly with the finding of an initial intra-abdominal pressure >20 mmHg and moderately with blunt injury mechanism. A lactic acid >5 mmol/L on admission was moderately associated with increased blood transfusion requirements and with acute renal failure during the hospitalization. Developing ACS within 48 h of admission was moderately associated with increased length of stay in the Intensive Care Unit (ICU), more ventilator days, and longer hospital stay. Initial operative intervention lasting more than 2 h was moderately associated with risk of developing multi-organ failure. Hemoglobin level <10 g/dL on admission, ongoing mechanical ventilation, and ICU stay >7 days were moderately associated with a disposition to long-term support facility.

Conclusions: Clinical and lab variables can predict specific adverse outcomes in trauma patients with ACS. These findings may be used to guide patient management, improve resource utilization, and build capacity within trauma centers.

Keywords: Abdominal compartment syndrome; acute renal failure; acute respiratory distress syndrome; complications; intra-abdominal hypertension; length of stay; markers; multi-organ failure; patient outcomes; risk factors; trauma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient selection
See this image and copyright information in PMC

References

    1. Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, et al. Prevalence of intra-abdominal hypertension in critically ill patients: A multicentre epidemiological study. Intensive Care Med. 2004;30:822–9. - PubMed
    1. Ivatury RR, Porter JM, Simon RJ, Islam S, John R, Stahl WM. Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: Prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma. 1998;44:1016–21. - PubMed
    1. Daugherty EL, Hongyan Liang, Taichman D, Hansen-Flaschen J, Fuchs BD. Abdominal compartment syndrome is common in medical intensive care unit patients receiving large-volume resuscitation. J Intensive Care Med. 2007;22:294–9. - PubMed
    1. Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I Definitions. Intensive Care Med. 2006;32:1722–32. - PubMed
    1. Hong JJ, Cohn SM, Perez JM, Dolich MO, Brown M, McKenney MG. Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndrome. Br J Surg. 2002;89:591–6. - PubMed