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Risk Factors and Outcome of Intra-abdominal Hypertension in Patients with Severe Acute Pancreatitis

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Abstract

Background

Intra-abdominal hypertension (IAH) is common in patients with severe acute pancreatitis (SAP). The aim of the present study was to investigate the risk factors of IAH in SAP patients and assess the prognosis of SAP combined with IAH.

Methods

To analyze the data from patients with SAP, both univariate and multivariate logistic regression analyses were applied, using 16 indices, including age, gender, Acute Physiology and Chronic Health Evaluation II scores (APACHE II), 24 h fluid balance, hematocrit, serum calcium level, and so on. Clinical prognosis such as mortality, hospital duration, of SAP patients with or without IAH was also compared.

Results

First 24 h fluid balance (Odds Ratio [OR], 1.003; 95% Confidence Interval [CI], 1.001–1.006), number of fluid collections (OR, 1.652; 95% CI, 1.023–2.956), and serum calcium level (OR, 0.132; 95% CI, 0.012–0.775) were found to be independent risk factors for IAH in patients with SAP. Moreover, patients with SAP and IAH had significantly longer average length of stay, both in the hospital and in the intensive care unit, higher rates of systemic and local complications, and more invasive treatments.

Conclusions

The significant risk factors for IAH in patients with SAP include 24 h fluid balance (first day), number of fluid collections, and serum calcium level. Additionally, IAH is associated with extremely poor prognosis, evidenced by high rates of mortality, morbidity, and the need for invasive interventions.

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Authors and Affiliations

  1. Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, People’s Republic of China

    Lu Ke, Hai-bin Ni, Jia-kui Sun, Zhi-hui Tong, Wei-qin Li, Ning Li & Jie-shou Li

  2. Department of SICU, Research Institute of General Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu, People’s Republic of China

    Wei-qin Li

Authors
  1. Lu Ke
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  2. Hai-bin Ni
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  3. Jia-kui Sun
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  4. Zhi-hui Tong
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  5. Wei-qin Li
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  6. Ning Li
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  7. Jie-shou Li
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Correspondence to Wei-qin Li.

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Ke, L., Ni, Hb., Sun, Jk. et al. Risk Factors and Outcome of Intra-abdominal Hypertension in Patients with Severe Acute Pancreatitis. World J Surg 36, 171–178 (2012). https://doi.org/10.1007/s00268-011-1295-0

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  • DOI: https://doi.org/10.1007/s00268-011-1295-0

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