Factores de riesgo asociados al desarrollo de síndrome compartimental abdominal en trauma de abdomen en pacientes de 18 a 65 años sometidos a laparotomía exploradora en el Hospital General Guasmo Sur, 2021–2024.

Abstract

Introduction: Abdominal compartment syndrome (ACS) is a severe complication that may be associated with abdominal trauma and is characterized by hemodynamic alterations, intensive resuscitation, and organ dysfunction. Objective: To analyze the clinical, hemodynamic, resuscitation, and perioperative factors associated with the development of abdominal compartment syndrome in patients with abdominal trauma who underwent exploratory laparotomy at Hospital General Guasmo Sur during the 2021–2024 period. Methodology: A quantitative, observational, analytical study with a retrospective cohort design was conducted. The sample consisted of 345 patients, including 151 with ACS and 194 without ACS. Results: The cumulative incidence was 7%. AAST-OIS grade V severity showed an OR of 28.27, while the damage-control procedure showed an OR of 23.47. In the adjusted model, the factors associated with ACS were an open abdomen (OR=9.83; 95% CI: 4.24–22.77; p<0.001) and each additional 1,000 mL of crystalloid fluids administered (OR=4.90; 95% CI: 2.80–8.55; p<0.001). Conclusion: Open abdomen and a higher volume of crystalloid fluids were the main factors independently associated with ACS. The syndrome was related to increased in-hospital mortality and greater clinical severity.