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

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 immun