| Abstract: Background and aims: Severe acute pancreatitis (SAP) is one of the clinical conditions associated with increased intra-abdominal pressure (IAP). This study examines factors associated with high IAP and its effect on hospital mortality in this patient group.
Methods: During 2001-2003 IAP was measured by intravesical route in 37 patients with SAP suspected to have intra-abdominal hypertension. The median age was 46 years, 33 were male, and in the majority of cases SAP was caused by alcohol abuse. Based on the highest measured IAP value, the patients were divided in two groups: IAP higher than 25 mmHg (Group 1) and IAP below 25 mmHg (Group 2). Two-tail Fisher exact and Mann-Whitney tests, Spearman´s non-parametric correlations, and logistic regression analysis were used for comparison, when appropriate.
Results: Of 37 patients, 10 (27%) had elevated IAP. The hospital mortality rate was 50% in Group 1 and 15% in Group 2 (p=0.04). Table 1 summarizes the other results.
The maximal IAP and the maximal SOFA (Sequential Organ Failure Assessment) were correlated (coefficient 0.41, p=0.01). Only maximal SOFA, but not maximal IAP, was independently associated with hospital mortality by logistic regression analysis.
Conclusions: Increased intra-abdominal pressure in SAP is associated with increased mortality. In addition, patients with SAP and with increased intra-abdominal pressure need prolonged intensive care. In all patients with SAP routine measurement of IAP is justified.
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