THE PREVALENCE OF ABDOMINAL COMPARTMENT SYNDROME IN THE STATE OF FLORIDA

Sunday, February 12, 2023

7:00am – 8:00am East Coast USA Time

Presenter(s)

LM

Laura Mena Albors, MD (she/her/hers)

General Surgery Resident
University of Central Florida, Florida, United States

Principal Contact(s)

JC

Jason Clark, MD

Director of General Surgery Residency
HCA Healthcare/Mercer University School of Medicine, United States

Objectives: Abdominal compartment syndrome (ACS) is the sustained intra-abdominal pressure of >20 mmHg in association with new organ dysfunction. Multiple studies have evaluated the prevalence of ACS at the single institutional level and/or for brief duration of time. To date, no study has looked at the change of incidence over an extended longitudinal period or included non-academic institutions. This study aims to evaluate the trend of the prevalence of ACS over a 15 year period within the state of Florida.

Methods: This is a population based retrospective study using deidentified data from the Florida’s Agency of Healthcare Database (AHCA). The primary outcome was the development of ACS. Secondary outcomes were mortality, ICU days, number of surgeries, hospital days, and complication rates. Outcomes were risk adjusted using multivariable regression.

Results: Between 2006 and 2021, 16,217,617 patients were admitted to the ICU with 4,002 developing abdominal compartment syndrome. Patients who developed ACS were typically younger (>64, 34.9% v 55.3%, p< 0.0001), male (65.3% v 51.2%, p< 0.0001), and likely to have to been diagnosed with shock during their hospital course compared to the overall ICU population. ACS patients were more likely to be self-pay (6.3% v 5.5%, p=0.02) or Medicaid (18.9% v 10.3%, p< 0.001), and of minority background. The reported prevalence of ACS increased from 53 per million (2006) to 402 per million (2021) during the study period. Mortality for all ICU patients has changed little and has ranged from 4.06% to 7.2% while that of ACS has ranged from 39.4% to 55.4%. Hospital length of stay was higher for ACS compared to all ICU (26.6 v 6.7, P< 0.0001). Length of stay for ACS trended down from 29.8 days to 22.4 days during the time period while it trended up for all ICU patients (6.82 to 7.54 days). Complication rates remained relatively stable at 62.4% to 62.7% at the end of the study period.

Conclusion: The prevalence of ACS has increased over the years within the state of Florida. Mortality and complication rates have remained relatively unchanged during that same time period. Length of stay for ACS has decreased during that same time period.