The prevalence of Intraabdominal hypertension and its association with mortality in post emergency laparotomy at Hospital Tengku Ampuan Afzan (HTAA), Kuantan /
The purpose of this study was to measure the prevalence of Intraabdominal hypertension (IAH) and its complications in relation to mortality rate. A double-blind prospective study of all post emergency laparotomy general surgical patients in ICU HTAA, Kuantan from June 2014-June 2015. Intraabdominal...
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| Format: | Thesis |
| Language: | English |
| Published: |
Kuantan, Pahang :
Kulliyyah of Medicine, International Islamic University Malaysia,
2017
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| Subjects: | |
| Online Access: | Click here to view 1st 24 pages of the thesis. Members can view fulltext at the specified PCs in the library. |
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| Summary: | The purpose of this study was to measure the prevalence of Intraabdominal hypertension (IAH) and its complications in relation to mortality rate. A double-blind prospective study of all post emergency laparotomy general surgical patients in ICU HTAA, Kuantan from June 2014-June 2015. Intraabdominal pressure (IAP) was measured by intravesicular technique using a manometry; taken once daily (first reading within 24 hours of admission). If IAP exceeds 10mmHg, 2 subsequent readings were taken 4 to 6 hours apart. Data included the demographics, clinical, Sequential Organ Failure Assessment (SOFA) score and Acute Physiology And Chronic Health Evaluation II (APACHE II) score . We enrolled 51 patients, age of the subjects range from 14 to 82 with mean of age at 49.22 ± 17.35. Prevalence of IAH was 73% and 18% had abdominal compartment syndrome (ACS). Mean for SOFA and APACHE II score were 8.10 ± 4.920 and 14.57 ± 6.152, respectively. IAH (p=0.067), per se was found to be not associated with mortality but was associated with Acute Kidney Injury or Renal replacement Therapy (p=0.037), duration in ICU (p=0.005), duration on ventilator (p=0.005) and Max SOFA score (p=0.006). ACS (p=0.001) was found to have significant association to mortality, Acute Kidney Injury or Renal replacement Therapy (p=0.037), duration in ICU (p=0.044), duration on ventilator (p=0.024), Max SOFA score (p=<0.001), and higher surgical experience (p=0.009). The factors associated to mortality in this study were presence of AKI or RRT (p=0.001), duration on ventilator (p=0.021), SOFA score (p=0.001), and APACHE II score (p=0.003). Post laparotomy patients have a higher probability of developing IAH and ACS in this study. This furthermore stresses the importance of monitoring of IAH/IAP, in order to provide a timely identification, treatment and management of IAH in order to reduce the complications of organ dysfunction and ACS, and thus reducing the mortality rate. |
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| Physical Description: | ix, 61 leaves : illustrations ; 30cm. |
| Bibliography: | Includes bibliographical references (leaves 44-48). |