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Sitzung

Therapie thermischer Verletzungen
Ort: Raum 16a, 1. OG

Präsentation 6

Clinical characteristics and outcomes of burn patients with abdominal compartment syndrome

Kleinhapl, Julia¹; Palackic, Alen²; Branski, Ludwik³; Wolf, Steven¹; Hundeshagen, Gabriel²; Sabagh, Mohammadsadegh²

1: Department of Surgery, University of Texas Medical Branch, Galveston, Texas; 2: Department of Plastic, Hand and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany; 3: Shriners Children’s Texas, Galveston, Texas

Introduction: Abdominal compartment syndrome (ACS) is a severe and life-threatening complication in burn patients, often associated with excessive fluid resuscitation. While prior studies have described the acute physiologic course and early outcomes of ACS after burn injury, long-term outcomes among survivors, including abdominal wall complications, chronic pain, gastrointestinal dysfunction, and renal sequelae, remain incompletely characterized and are largely limited to small single-center series. The objective of this study was to evaluate risk factors and outcome associations in burn patients who subsequently developed ACS.

Methods: We conducted a retrospective cohort study using the real-world database TriNetX. Adult burn patients were identified using ICD-10 burn codes, and those who developed ACS within one month following burn injury were included. Burn patients without ACS were propensity score matched for comparative outcome analyses. Outcomes, including surgical procedures, were assessed at one month and one year after burn injury. Results are presented as absolute risks for single-cohort analyses and as risk ratios (RRs) with 95% confidence intervals (CIs) for matched outcome comparisons. Statistical significance was defined as p < 0.05.

Results: A total of 310 burn patients with ACS were identified, representing 0.03% of the total burn population in the database. Seventy percent of patients were male, with a mean age of 50 ± 23 years. Mortality among patients with ACS was 50.9% at one month and 66% at one year following burn injury. Renal and respiratory impairment were common and occurred at significantly higher rates compared with matched burn patients without ACS (p < 0.05). Sepsis developed in approximately half of patients with ACS. In addition, patients who developed ACS exhibited a substantial comorbidity burden, particularly with respect to pre-existing cardiovascular disease.

Conclusion: ACS is a rare but highly morbid complication following burn injury, associated with substantial short- and long-term mortality and organ dysfunction. Early recognition of at-risk patients and timely intervention are critical to mitigate downstream complications and improve outcomes.