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Abstract
Background/aim Intraabdominal hypertension (IAH) occurs frequently in patients with acute pancreatitis and adds to their morbidity and mortality. The main aim of the study was to identify the determination of the predictive factors connected to IAH that influence the evolution of acute pancreatitis. Materials and methods The prospective cohort study was conducted on 100 patients who had acute pancreatitis. According to obtained intraabdominal pressure (IAP) values, the patients were divided into two groups: one group (n = 40) with normal IAP values and the other (IAH group, n = 60) with increased IAP values. Deceased patients were specially analyzed within the IAH group in order to determine mortality predictors. Results Statistical significance of IAP (P = 0.048), lactates (P = 0.048), peak pressure (P = 0.043), abdominal perfusion pressure (P = 0.05), and mean arterial pressure (P = 0.041) was greater for deceased than for surviving patients in the IAH group. High mortality appears for patients younger than 65 years old, with lactate level higher than 3.22 mmol/L and filtration gradient (GF) lower than 67 mmHg. Conclusion Age, lactates, GF, and APACHE II score are determined as mortality predictors for patients suffering from acute pancreatitis who developed IAH. The mortality rate is higher when the level of GF is decreasing and the level of lactate increasing.
Highlights
The main aim of the study was to identify the determination of the predictive factors connected to intraabdominal hypertension (IAH) that influence the evolution of acute pancreatitis
High mortality appears for patients younger than 65 years old, with lactate level higher than 3.22 mmol/L and filtration gradient (GF) lower than 67 mmHg
Age, lactates, GF, and APACHE II score are determined as mortality predictors for patients suffering from acute pancreatitis who developed IAH
Summary
A number of studies show that intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are significant indicators of the morbidity and mortality of patients with acute pancreatitis [1,2,3]. An increase in intraabdominal pressure (IAP) above 12 mmHg leads to perfusion disorder of the intestinal organs, which, along with the existing microcirculatory disorder of the pancreas, leads to reduced oxygen delivery, development of necrotic formations in the pancreas, cytokine release, The maximum IAP; the Acute Physiological, Age, and Chronic Health Evaluation II (APACHE II) score; the maximum sequential organ failure assessment score; age; maximum lactate and creatinine; and base deficiency were previously found to be significantly increased in deceased patients with acute pancreatitis [8,9]. STOJANOVIC et al / Turk J Med Sci is to determine the predictive factors for development of IAH, which influences the evolution of acute pancreatitis
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