title: Advanced age may limit the survival benefit of open abdominal decompression.
abstract: Open abdominal decompression (OAD) and temporary abdominal closure (TAC) are widely performed for the treatment of intra-abdominal hypertension and/or abdominal compartment syndrome. During 2005 to 2009, 405 consecutive patients required OAD/TAC (trauma 68%, surgery 24%, medicine 5%,  burn 3%). Overall patient survival to hospital discharge was 65 per cent regardless of age and was significantly decreased among patients older than 70 years of age (P < 0.0001). Survival by decade of life exceeded 50 per cent through the eighth decade but decreased to 19 per cent  for the ninth decade (older than 80 years of age). Survival varied significantly by service (trauma 72%, surgical 56%, burns 55%, medical 33%) (P < 0.0001). Successful definitive fascial closure rates (range, 75 to 100%) were equivalent among all age groups (P = 0.78). Survival  after OAD/TAC varies by decade of life and mechanism of injury/illness. Age alone should not negate the use of OAD/TAC. Reasonable survival rates may be expected for patients younger than 80 years of age.
authors.affiliation: Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida, USA. michael.cheatham@orlandohealth.com
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cheatham
authors.forename: Karen
authors.initials: K
authors.lastname: Safcsak
authors.forename: Creighton
authors.initials: C
authors.lastname: Fiscina
authors.forename: Christopher
authors.initials: C
authors.lastname: Ducoin
authors.forename: Howard G
authors.initials: HG
authors.lastname: Smith
authors.forename: John T
authors.initials: JT
authors.lastname: Promes
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Lube
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003161:Compartment Syndromes / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality* / Q000601:surgery*; D008150:Lower Body Negative Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D055815:Young Adult