ArticleFrontiers in nutrition2026
Synergistic impact of nutritional risk, glycemic control, and systemic inflammation on Abdominal Compartment Syndrome in diabetic patients following complex ventral hernia repair: a development and validation study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Abdominal Compartment Syndrome (ACS) is a catastrophic complication following complex hernia repair, particularly in patients with Type 2 Diabetes Mellitus (T2DM) who exhibit a phenotype of "metabolic vulnerability." The interplay between preoperative nutritional depletion, chronic hyperglycemia, and systemic inflammation remains poorly understood in this context. Current risk assessment tools rely heavily on anatomical metrics and often fail to capture the synergistic impact of immuno-metabolic fragility. We aimed to develop and prospectively temporally validate a dynamic nomogram that integrates immuno-nutritional markers with surgical variables to predict ACS in diabetic patients. Methods: We conducted a two-stage, prospective temporal validation study involving 555 diabetic patients undergoing elective complex hernia repair at a tertiary referral center. Phase I (January 2015 to December 2021) comprised a retrospective derivation cohort ( Results: The study population exhibited a high baseline metabolic burden, with a mean body-mass index of 31.2 kg/m Conclusion: The integration of immuno-nutritional markers (SIRI, NRS-2002) and glycemic control with anatomical parameters provides a temporally validated tool with good and stable discrimination for ACS in diabetic patients. Its principal clinical utility lies in reliable risk exclusion (negative predictive value 95.5% in the prospective temporal validation cohort), supporting safe rule-out of low-risk patients, while the more modest positive predictive value (46.4%) indicates that a high score should prompt enhanced surveillance and individualized decision-making rather than constitute a deterministic indication for pre-emptive open-abdomen management.
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