Systematic review and meta-analysis reveals varying incidence and mortality risk in abdominal compartment syndrome by cause, suggesting treatments should account for underlying etiology.
Key Points
To determine whether abdominal compartment syndrome represents a uniform clinical entity or if incidence rates and mortality outcomes differ significantly according to the precipitating cause.
Conducted a PRISMA-compliant systematic review searching MEDLINE, Cochrane Reviews, Science Direct, and citation lists from January 2018 to January 2026.
Identified studies on adult patients (≥18 years) with abdominal compartment syndrome (ACS), using dual independent review and validation by a senior reviewer.
Extracted data from 100 manuscripts totaling 1,176,638 unique patients, including 90 reporting incidence, 33 reporting mortality, and 21 included in the meta-analysis comparing ACS to non-ACS controls.
Total incidence of ACS was 0.05% across 1,176,638 patients, with the highest rate observed in moderate-to-severe pancreatitis (15.16%) and a lower rate in trauma patients (0.22%).
The unadjusted association between ACS and mortality varied substantially by underlying pathology, showing no observed association in ECMO patients, a moderate association in trauma (OR 3.15; 95% CI 2.24, 4.43), and a large association in non-trauma cases (OR 8.60; 95% CI 4.60, 16.07).