18. RISK FACTORS FOR EVISCERATION IN PATIENTS UNDERGOING MIDLINE LAPAROTOMY AT A TERTIARY HOSPITAL

Abstract

Abstract Introduction Evisceration is a frequent complication in patients undergoing median laparotomy that results in a significant increase in morbidity and mortality, hospital stay and healthcare expenditure. Numerous risk factors associated with the appearance of this complication have been described without being able to determine the individual influence of each one of them. Our aim is to describe the most frequent risk factors in our sample. Methods We retrospectively collected all eviscerations registered in our center between January 1, 2010 and December 31, 2020 in patients undergoing median laparotomy. Seventy-five cases were recruited. Seventy-five controls undergoing median laparotomy in the same time period were collected and associated risk factors were analyzed. Results The risk factors that were statistically significant were male sex (protective factor with OR 6.4 CI95% 3.4-7.6), COPD (OR 5.6 CI95% 1.69-19.9), surgical wound infection (OR 3.49 CI95% 1.86-14.1), ileus (OR 14.7 CI95% 1.66-131.40) and anastomotic dehiscence (OR 7.58 CI95% 1.76-32.50). No statistically significant differences were found between the different types of sutures used for abdominal wall closure. 92% of the cases underwent surgical repair, 8% were managed conservatively. Postoperative mortality was 16%. Conclusion The occurrence of evisceration appears to be related to risk factors associated with the patients' pre-existing comorbidities and postoperative complications.