{Reference Type}: Journal Article
{Title}: Is open abdominal management useful in nontrauma emergency surgery for older adults? A single-center retrospective study.
{Author}: Okishio Y;Ueda K;Nasu T;Kawashima S;Kunitatsu K;Kato S;
{Journal}: Surg Today
{Volume}: 51
{Issue}: 8
{Year}: Aug 2021
{Factor}: 2.54
{DOI}: 10.1007/s00595-020-02214-0
{Abstract}: <B>OBJECTIVE: </B>Open abdominal management (OAM) is being adopted increasingly frequently in nontrauma patients. This study assessed the effectiveness of OAM in nontrauma older adults.<BR><B>METHODS: </B>We retrospectively reviewed all adults who underwent nontrauma emergency laparotomy requiring postoperative intensive care unit (ICU) management between September 2012 and August 2017 at our hospital. Patients ≥ 80 years old, who underwent OAM, were compared with those < 80 years old. The primary outcome was the 90-day mortality. Secondary outcomes were the 30-day mortality, unplanned relaparotomy, and the ICU length of stay (LOS).<BR><B>RESULTS: </B>The OAM group comprised 58 patients, including 27 who were ≥ 80 years old. The patients ≥ 80 years old in the OAM group had a significantly higher 90-day mortality rate (33% vs. 10%; p = 0.027) than those < 80 years old. There were no significant differences in the 30-day mortality rate, patients' unplanned relaparotomy rate, or ICU LOS between the patients ≥ 80 years old and those < 80 in the OAM group.<BR><B>CONCLUSIONS: </B>Older adults who underwent OAM had a significantly higher mortality rate than younger patients. However, the OAM strategy for older nontrauma patients may still be useful and reasonable considering the severe condition of these patients.