Intra-abdominal hypertension in severe burns: prevalence, incidence and mortality in a sub-Saharan African hospital
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Date
2017
Authors
Mbiine, Ronald
Alenyo, Rose
Kobusingye, Olive
Kuteesa, Job
Nakanwagi, Cephas
Monka Lekuya, Hervé
Kituuka, Olivia
Galukande, Moses
Journal Title
Journal ISSN
Volume Title
Publisher
International journal of burns and trauma
Abstract
Severe burns have been shown to be a risk factor for developing intra-abdominal hypertension
(IAH). Fluid resuscitation practices used in burns management further predispose patients to intra-abdominal
hypertension. The mortality associated with IAH in severe burns is estimated to be more than 74.5% once organ
dysfunction occurs. Despite 95% of all burns occurring in Low and Middle income countries (LMIC), there is paucity
of published data on this topic in sub-Saharan Africa. Objectives: To determine the prevalence, incidence, organ
dysfunction and mortality of intra-abdominal hypertension among severe burns patients. Methods: A prospective
cohort study was conducted over a 6 months period in the Burns Unit of Mulago National Referral Hospital. Patients
of all age groups with burns ≥25% and 20% in adults and children respectively were recruited and followed up for
7 days or until death occurred. Patients with burns older than 48 hours were excluded. The outcome variables
were intra-abdominal pressure, organ dysfunction and seven day mortality. Results: Of all the 335 burns patients
admitted, 64 patients met the inclusion criteria. The overall prevalence of IAH was 57.8% while the prevalence in
the children and adults was 54.5% and 61.3% respectively. The incidence of IAH was 13.1 cases/100 person days
with the incidence in adults being twice that of the children. The one week mortality of patients with IAH was 82.6%
with the risk of dying being 3.34 (p=0.0035) and seven day survival being less than 50%. Conclusion: One in two
patients with severe burns exceeding 20% or 25% in children or adults respectively developed IAH. Adults had a
higher prevalence and incidence of IAH. Mortality associated with IAH exceeded 80%.
Description
Keywords
Intra-abdominal hypertension, severe burns, abdominal compartment syndrome, sub-Saharan Africa, Uganda, Africa, outcome, mortality
Citation
Mbiine, R., Alenyo, R., Kobusingye, O., Kuteesa, J., Nakanwagi, C., Lekuya, H. M., ... & Galukande, M. (2017). Intra-abdominal hypertension in severe burns: prevalence, incidence and mortality in a sub-Saharan African hospital. International journal of burns and trauma, 7(6), 80.