Correlation between Raised Intra-Abdominal Pressure and Its Outcome in Patients Undergoing Emergency Laparotomy

Abstract

Background
Raised intra-abdominal pressure is an important factor affecting the operative outcome in laparotomy. Intra-abdominal pressure greater than 12 mmHg is called IAH (Intra-Abdominal Hypertension). This study was conducted to predict early and timely intervention and hence, to improve the outcome of patients undergoing emergency laparotomies.
Aims
To assess intra-abdominal pressure as one of the predictors of outcome in patients undergoing emergency laparotomy.
Methods
104 patients who underwent emergency laparotomy in RIMS were selected and IAP was taken pre-operatively and then post-operatively at 0, 6, 24 and 72 hrs. Other hemodynamic parameters were measured to assess cardiopulmonary and renal functions.
Results
Our study found that the pre- and post-IAP were 14.3±3.4 mm Hg and 6.3±3.2 mm Hg respectively. The incidence of IAH in our study was 84.5% at the time of admission, 1.9% at 0 hour, 25.9% at 6 hours, 10.4% at 24 hours and 8.5% at 72 hours post-operatively.
Conclusions
Pre-operative intra-abdominal pressure at and above 15.5 mm Hg is a predictor of postoperative outcomes with a sensitivity of 65% and a specificity of 80%. Intra-abdominal pressure measurement can be used as an independent clinical parameter to assess the patient’s  current clinical condition. Intra-abdominal pressure measurement also helps in prioritizing
surgical intervention in emergencies.