Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Federico Coccolini, Marco Ceresoli, Yoram Kluger, Andrew Kirkpatrick, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Matteo Tomasoni, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis IoannidisGiuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, 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 Arellano, 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 Gianotti, Luca Fattori, Rao Ivatury

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalInjury
Volume50
Issue number1
DOIs
Publication statusPublished - Jan 1 2019
Externally publishedYes

Fingerprint

Abdomen
Fistula
Peritonitis
Abdominal Wound Closure Techniques
Mortality
Wounds and Injuries
Enteral Nutrition
Nutritional Status
Emergencies
Multivariate Analysis
Pressure
Therapeutics

Keywords

  • Entero-atmospheric fistula
  • Fistula
  • IROA
  • Open abdomen

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Coccolini, F., Ceresoli, M., Kluger, Y., Kirkpatrick, A., Montori, G., Salvetti, F., ... Ivatury, R. (2019). Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA). Injury, 50(1), 160-166. https://doi.org/10.1016/j.injury.2018.09.040

Open abdomen and entero-atmospheric fistulae : An interim analysis from the International Register of Open Abdomen (IROA). / Coccolini, Federico; Ceresoli, Marco; Kluger, Yoram; Kirkpatrick, Andrew; Montori, Giulia; Salvetti, Fracensco; Fugazzola, Paola; Tomasoni, Matteo; Sartelli, Massimo; Ansaloni, Luca; Catena, Fausto; Negoi, Ionut; Zese, Monica; Occhionorelli, Savino; Shlyapnikov, Sergei; Galatioto, Christian; Chiarugi, Massimo; Demetrashvili, Zaza; Dondossola, Daniele; Ioannidis, Orestis; Novelli, Giuseppe; Nacoti, Mirco; Khor, Desmond; Inaba, Kenji; Demetriades, Demetrios; Kaussen, Torsten; Jusoh, Asri Che; Ghannam, Wagih; Sakakushev, Boris; Guetta, Ohad; Dogjani, Agron; Costa, Stefano; Singh, Sandeep; Damaskos, Dimitrios; Isik, Arda; Yuan, Kuo Ching; Trotta, Francesco; Rausei, Stefano; Martinez-Perez, Aleix; Bellanova, Giovanni; Fonseca, Vinicius Cordeiro; Hernández, Fernando; Marinis, Athanasios; Fernandes, Wellington; Quiodettis, Martha; Bala, Miklosh; Vereczkei, Andras; Curado, Rafael; Fraga, Gustavo Pereira; Pereira, Bruno M.; Gachabayov, Mahir; Chagerben, Guillermo Perez; Arellano, Miguel Leon; Ozyazici, Sefa; Costa, Gianluca; Tezcaner, Tugan; Porta, Matteo; Li, Yousheng; Karateke, Faruk; Manatakis, Dimitrios; Mariani, Federico; Lora, Federic; Sahderov, Ivan; Atanasov, Boyko; Zegarra, Sergio; Gianotti, Luca; Fattori, Luca; Ivatury, Rao.

In: Injury, Vol. 50, No. 1, 01.01.2019, p. 160-166.

Research output: Contribution to journalArticle

Coccolini, F, Ceresoli, M, Kluger, Y, Kirkpatrick, A, Montori, G, Salvetti, F, Fugazzola, P, Tomasoni, M, Sartelli, M, Ansaloni, L, Catena, F, Negoi, I, Zese, M, Occhionorelli, S, 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, Ghannam, 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, Arellano, 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, Gianotti, L, Fattori, L & Ivatury, R 2019, 'Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)', Injury, vol. 50, no. 1, pp. 160-166. https://doi.org/10.1016/j.injury.2018.09.040
Coccolini, Federico ; Ceresoli, Marco ; Kluger, Yoram ; Kirkpatrick, Andrew ; Montori, Giulia ; Salvetti, Fracensco ; Fugazzola, Paola ; Tomasoni, Matteo ; Sartelli, Massimo ; Ansaloni, Luca ; Catena, Fausto ; Negoi, Ionut ; Zese, Monica ; Occhionorelli, Savino ; Shlyapnikov, Sergei ; Galatioto, Christian ; Chiarugi, Massimo ; Demetrashvili, Zaza ; Dondossola, Daniele ; Ioannidis, Orestis ; Novelli, Giuseppe ; Nacoti, Mirco ; Khor, Desmond ; Inaba, Kenji ; Demetriades, Demetrios ; Kaussen, Torsten ; Jusoh, Asri Che ; Ghannam, Wagih ; Sakakushev, Boris ; Guetta, Ohad ; Dogjani, Agron ; Costa, Stefano ; Singh, Sandeep ; Damaskos, Dimitrios ; Isik, Arda ; Yuan, Kuo Ching ; Trotta, Francesco ; Rausei, Stefano ; Martinez-Perez, Aleix ; Bellanova, Giovanni ; Fonseca, Vinicius Cordeiro ; Hernández, Fernando ; Marinis, Athanasios ; Fernandes, Wellington ; Quiodettis, Martha ; Bala, Miklosh ; Vereczkei, Andras ; Curado, Rafael ; Fraga, Gustavo Pereira ; Pereira, Bruno M. ; Gachabayov, Mahir ; Chagerben, Guillermo Perez ; Arellano, Miguel Leon ; Ozyazici, Sefa ; Costa, Gianluca ; Tezcaner, Tugan ; Porta, Matteo ; Li, Yousheng ; Karateke, Faruk ; Manatakis, Dimitrios ; Mariani, Federico ; Lora, Federic ; Sahderov, Ivan ; Atanasov, Boyko ; Zegarra, Sergio ; Gianotti, Luca ; Fattori, Luca ; Ivatury, Rao. / Open abdomen and entero-atmospheric fistulae : An interim analysis from the International Register of Open Abdomen (IROA). In: Injury. 2019 ; Vol. 50, No. 1. pp. 160-166.
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abstract = "Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9{\%}) developed EAF. Indications for OA were peritonitis (51.2{\%}) and traumatic-injury (16.8{\%}). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8{\%}) and Bogot{\`a}-bag (21.9{\%}). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7{\%}, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.",
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T1 - Open abdomen and entero-atmospheric fistulae

T2 - An interim analysis from the International Register of Open Abdomen (IROA)

AU - Coccolini, Federico

AU - Ceresoli, Marco

AU - Kluger, Yoram

AU - Kirkpatrick, Andrew

AU - Montori, Giulia

AU - Salvetti, Fracensco

AU - Fugazzola, Paola

AU - Tomasoni, Matteo

AU - Sartelli, Massimo

AU - Ansaloni, Luca

AU - Catena, Fausto

AU - Negoi, Ionut

AU - Zese, Monica

AU - Occhionorelli, Savino

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 - 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

AU - Vereczkei, Andras

AU - Curado, Rafael

AU - Fraga, Gustavo Pereira

AU - Pereira, Bruno M.

AU - Gachabayov, Mahir

AU - Chagerben, Guillermo Perez

AU - Arellano, 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 - Gianotti, Luca

AU - Fattori, Luca

AU - Ivatury, Rao

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.

AB - Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.

KW - Entero-atmospheric fistula

KW - Fistula

KW - IROA

KW - Open abdomen

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