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Excerpt
Aim of this study was to evaluate in all the new patients admitted to general ICUs, during four weeks, the incidence of IAP and if IAP at admission could be an independent risk factor for the ICU mortality. At admission: APACHE II, etiologic factors (abdominal surgery, hemoperitoneum, abdominal infection, massive fluid resuscitation, ileus, pneumonia, bacteraemia), predisposing conditions (acidosis, polytransfusion, coagulopathy, sepsis and liver dysfunction) and type of admission were evaluated. The IAP was measured twice every day, for seven days or less if ICU discharged or dead occurred.
Materials and Methods: 265 patients were enrolled from ICUs, mean age 62.8 ± 17.7y, BMI 25.9 ± 17.7 kg/m2, APACHE II 17.8 ± 8.7, IAP 9.7 ± 5.0 mmHg, medical patients 132 (49.8%), surgical patients 71 (26.8%), emergency patients 42 (15.8%), trauma patients 20 (7.6%) and ICU stay 9.5 ± 11.2 die.
Results and Discussions: The incidence of IAH (defined as a mean IAP of 12 mmHg or more at admission) was 23.7%, 62 patients (23.4%) died in ICU.
The only independent risk factors for death in ICU were mean IAP at admission (OR 1.5 CI 1.0-2.3), APACHE II (OR 1.1 CI 1.0-1.1) and liver dysfunction (OR 4.0 CI 1.6-9.8).
Conclusion(s): These data suggest that in a mixed population of critically ill patients the IAH is a quite common problem and moreover the IAP is independently associated ICU death.
