Incidence and Prognostic Factors for Mortality of Abdominal Hypertension in Critically Ill Surgical Patients in THAI-SICU Study
Osaree Akaraborworn MD, MSc*1, Kaweesak Chittawatanarat MD, PhD*2, Chanon Kongkamol MD*3, Sunisa Chatmongkolchart MD*4, Chanatthee Kitsiripant MD*4, the THAI-SICU study group
Affiliation : *1 Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand *2 Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand *3 Research Unit of Holistic Health and Safety Management in Community, Prince of Songkla University, Songkhla, Thailand *4 Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Objective : This study aimed to investigate the incidence and prognostic factors of mortality in intra-abdominal hypertension
that developed during admission in the surgical intensive care units in Thailand.
Material and Method: This was a prospective observational study in nine university-based surgical intensive care units in
Thailand. (THAI-SICU) The suspected patients who had the intra-abdominal pressure more than 12 mmHg were defined as
intra-abdominal hypertension (IAH). The patients were followed until discharge.
Results : Among 4,652 cases, a total of 71 cases (1.5%) developed IAH. The average age was 53.05+20.26 years. The median
APACHE II score was 13 (9-15). Eighteen patients received surgical decompression as treatment. Metabolic acidosis (pH
<7.2) and abdominal aortic surgery were the significant factors for mortality in intra-abdominal hypertension patients.
Conclusion : The incidence of intra-abdominal hypertension in the critical surgical care units was low in this cohort. Intra-
abdominal hypertension in patients who previously received abdominal aortic surgery and who had concomitant acidosis
was the independent risk factor of mortality.
Keywords : Intra-abdominal hypertension, Critical care, Mortality, Compartment syndrome
