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Intra-abdominal Hypertension Is a Strong Predictor of Mortality and Poor Clinical Outcome in Severe Acute Pancreatitis.

Intra-abdominal Hypertension Is a Strong Predictor of Mortality and Poor Clinical Outcome in Severe Acute Pancreatitis.

Authors :
Darweesh M
El-Kurdi B
Mahfouz R
Haddaden M
Mansour M
Obeidat AE
Ghanem F
Young MF
Source :
Digestive diseases and sciences [Dig Dis Sci] 2024 Dec 20. Date of Electronic Publication: 2024 Dec 20.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Background: Acute pancreatitis is one of the leading causes of mortality and morbidity. Most acute pancreatitis scoring systems have no pathophysiologic basis when evaluating severity. Such a limitation led to an interest in measuring intra-abdominal pressure (IAP) as a method to predict outcomes in patients with acute pancreatitis.<br />Aims: Investigate the predictive impact of intra-abdominal hypertension (IAH) on mortality and clinical outcomes in a patient hospitalized with severe acute pancreatitis.<br />Methods: We conducted a systematic search of the PubMed, Embase, and Cochrane databases from inception through November 2021 for studies evaluating the effect of IAH on acute pancreatitis. Relevant data were extracted and analyzed using STATA 17 software. A random-effects model was used for all variables. Publication bias was assessed using Egger's test.<br />Results: Fourteen studies investigating 1197 patients were included. Mortality, multiorgan dysfunction syndrome, pancreatic necrosis, renal, respiratory, and cardiovascular failure were more likely in the IAH group. However, infected necrosis and surgical intervention were not statistically significant between the two groups. After excluding abdominal compartment syndrome patients, mortality and respiratory failure were the only outcomes, which remained statistically significant.<br />Conclusions: Patients admitted to the hospital with severe acute pancreatitis have higher odds for mortality, multiorgan dysfunction syndrome, renal, respiratory, and cardiovascular failure if they developed IAH. IAH remained a strong predictor of mortality and respiratory failure even in the absence of abdominal compartment syndrome. Therefore, the development of IAH is a strong predictor of mortality and poor clinical outcome in such a population.<br />Competing Interests: Declarations. Conflict of interest: All authors have no conflicts of interest. No financial arrangements are related to the research or assistance with manuscript preparation.<br /> (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Details

Language :
English
ISSN :
1573-2568
Database :
MEDLINE
Journal :
Digestive diseases and sciences
Publication Type :
Academic Journal
Accession number :
39704902
Full Text :
https://doi.org/10.1007/s10620-024-08749-3