Risk Factors and Clinical Prognosis for the Development of Intra-Abdominal Hypertension in Patients with Acute Pancreatitis: An Observational Retrospective Analysis

Xiong Y*

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, China

^*Correspondance to: Xiong Y 

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Abstract:

Background: Intra-Abdominal Hypertension (IAH) is a pathological condition in which the Intra-Abdominal Pressure (IAP) rises above the standard range. IAH is very prevalent in patients with Acute Pancreatitis (AP), and it is an essential factor contributing to the high mortality rate in patients with AP. There are no validated tools to forecast the appearance of IAH. The purpose of this study was to identify risk factors for IAH in patients with AP and to establish a prediction model based on them that would help clinicians determine whether a patient has IAH. Methods: We gathered the retrospective data of 383 patients with AP. By accumulating their statistical demographic characteristics, serologic indicators and in/out volume, we constructed a Nomogram prediction model based on associated risk elements screened using a binary logistic regression method. The accuracy of this prediction model was also assessed with the area under the subject's curve. Results: In this study, we conclude that there was a remarkable discrepancy between the IAH and non-IAH groups and that mortality was substantially more in the IAH group (43.4% vs. 7.6%, (P<0.001)). By using logistic regression, we filtered out six risk factors for IAH, namely blood urea nitrogen (P<0.008, OR 1.197), C-reactive protein (P<0.001, OR 1. 008), serum calcium (P<0.007, OR 0.098), 24-h urine volume (P<0.009, OR 0.443), 24-h fluid volume (P<0.001, OR 2.348) and central venous pressure (P<0.001, OR 1.834). Based on these risk variables, a prediction model was constructed and its accuracy was to be evaluated with the calibration curve and the area under the receiver operating characteristic curve. The results showed that the model had excellent predictive performance (0.952 vs. 0.912). Conclusion: This study identifies that IAH can impinge on the survival of AP patients and constructs a predictive model for IAH to help clinicians better diagnose the occurrence of IAH.

Keywords:

Intra-abdominal hypertension; Acute pancreatitis; Risk factors; Mortality; Prediction model

Cite the Article:

Xiong Y. Risk Factors and Clinical Prognosis for the Development of Intra-Abdominal Hypertension in Patients with Acute Pancreatitis: An Observational Retrospective Analysis. Ann Clin Case Rep. 2023; 8: 2525.