Intra-abdominal hypertension in severe burns: prevalence, incidence and mortality in a sub-Saharan African hospital
Loading...
Date
2017
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.