Department of Gastroenterology and Hepatology, Clinical Center of "Zvezdara", Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Turk J Med Sci. 2017 Jun 12;47(3):748-753. doi: 10.3906/sag-1509-7.
BACKGROUND/AIM: Intraabdominal hypertension (IAH) is a common clinical finding in patients with acute pancreatitis and is associated with poor prognosis. This study aimed to determine the impact of intraabdominal pressure (IAP) on the mortality rate in patients with acute pancreatitis in an intensive care unit.
A total of 50 patients with acute pancreatitis were included in this prospective cohort study. Based on the obtained values of IAP, the patients were divided into two groups: those with normal IAP (n = 14) and increased IAP (n = 36). Mean values of IAP were compared with examined variables.
The mortality rate of the study group was 40%. Comparing the IAP and treatment outcomes, it was proved that there were statistically highly significant differences (P = 0.012). Increasing the value of IAP increased the mortality rate. Deceased patients in the IAH group had greater statistical significance of APACHE II score (P = 0.016), abdominal perfusion pressure (P = 0.048), lactate (P = 0.049), hematocrit (P = 0.039), Ranson's criteria on admission (P = 0.017), Ranson's criteria after 48 h (P = 0.010), Sequential Organ Failure Assessment score (P = 0.014), and body mass index (P = 0.012) compared to the surviving patients.
IAP has an impact on the increase of mortality rates in patients with acute pancreatitis.
背景/目的：腹腔内高压（IAH）是急性胰腺炎患者的常见临床发现，并与预后不良相关。本研究旨在确定重症监护病房中急性胰腺炎患者的腹腔内压（IAP）对死亡率的影响。
本前瞻性队列研究共纳入 50 例急性胰腺炎患者。根据 IAP 的测量值，患者被分为两组：正常 IAP 组（n = 14）和 IAP 升高组（n = 36）。比较 IAP 的平均值与检查变量。
研究组的死亡率为 40%。比较 IAP 和治疗结果，证明存在统计学上高度显著的差异（P = 0.012）。IAP 值的增加增加了死亡率。在 IAH 组中，APACHE II 评分（P = 0.016）、腹主动脉灌注压（P = 0.048）、乳酸（P = 0.049）、红细胞压积（P = 0.039）、入院时的 Ranson 标准（P = 0.017）、48 小时后 Ranson 标准（P = 0.010）、序贯器官衰竭评估评分（P = 0.014）和体重指数（P = 0.012）的死亡患者具有更高的统计学意义。
IAP 对急性胰腺炎患者死亡率的增加有影响。
