Synergistic impact of nutritional risk, glycemic control, and systemic inflammation on Abdominal Compartment…

Cohort studyFrontiers in nutrition· 2026

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.

Xue Zhang, Yingmo Shen, Baoshan Wang, Jie Chen

Hernia & Abdominal WallCohort studyQ1IF 5.2

Immuno-nutritional-metabolic nomogram predicts abdominal compartment syndrome accurately after diabetic hernia repair

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.

Xue Zhang … Jie Chen

Frontiers in nutrition · 2026

Background

Abdominal Compartment Syndrome (Abdominal Compartment Syndrome) 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.

Purpose

We aimed to develop and prospectively temporally validate a dynamic nomogram that integrates immuno-nutritional markers with surgical variables to predict Abdominal Compartment Syndrome 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.

n = 461

Results

AUC measuring predictive accuracy for compartment syndrome; 1.0 is perfect, 0.5 is chance

OR 2.75 (95% CI 1.60 to 4.85)

null 1

1.60

4.85

CI excludes the null - significant

More results

The study population exhibited a high baseline metabolic burden, with a mean body-mass index of 31.2 kg/m 2 and a mean HbA1c of 7.9%.

More results

Multivariable logistic regression identified seven independent predictors: HSV/ACV ratio ≥ 0.25 (Odds Ratio [OR], 2.75; 95% Confidence Interval [CI], 1.60-4.85), use of tension reduction procedures (OR, 2.45), operative time > 200 min (OR, 2.12), BMI ≥ 30 kg/m 2 (OR, 1.88), NRS-2002 score ≥ 3 (OR, 2.18), Systemic Inflammatory Response Index ≥ 1.6 (OR, 1.98), and HbA1c ≥ 6.0% (OR, 1.65).

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Conclusion

The integration of immuno-nutritional markers (Systemic Inflammatory Response Index, NRS-2002) and glycemic control with anatomical parameters provides a temporally validated tool with good and stable discrimination for Abdominal Compartment Syndrome in diabetic patients.

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.

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.

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