Intraabdominal pressure at ICU admission: Evaluation as a predictor of severity and mortality in severe acute pancreatitis

Abstract

Background and aims. Approximately 20% of acute pancreatitis progresses to a severe form characterised by multiple extrapancreatic organ dysfunction. Elevated intra-abdominal pressure (IAP), a frequent finding in these patients, further adds to the mortality. Currently used prognostication indices have their own set of limitations. We evaluated intra-abdominal pressure at intensive care unit (ICU) admission as a predictor of mortality in severe acute pancreatitis (SAP). Methods. A retrospective analysis of 50 patients with SAP admitted to the ICU of a tertiary-care Indian institute over a period of 3 years was done. Data relating to demographic profile, cause of pancreatitis, ICU admission, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, IAP, interventions instituted and mortality were analysed. Results. Biliary stones (38%) were the most common cause of acute pancreatitis. Survivors differed from non-survivors with respect to organ failure, APACHE II and SOFA scores and IAP on admission. There was a significant correlation between IAP on ICU admission and admission SOFA (r=0.56, p