Effect of abdominal perfusion pressure on prognosis of patients with severe acute pancreatitis

Objective To observe the effects of abdominal perfusion pressure（APP） on the prognosis of patients with severe acute pancreatitis（SAP） and compare the effects of intra-abdominal pressure（IAP）,APACHE Ⅱ-score and APP on the mortality rate of SAP patients. Methods Thirty-six SAP patients,admitted to the ICU of Emergency Department in our hospital from December 2007 to August 2009,were enrolled in this study.Their IAP and APP were measured daily and scored with APACHE-Ⅱ. Results Of the 36 patients,23（64%）developed a high IAP on admission and their mortality rate was 56.5%.The mortality rate of those with their APP＜7.98kPa was higher than that of those with their APP≥7.98kPa（90.9% vs 12%,P＜0.01）.APP was positively correlated with APACHE-Ⅱscore（r=0.938,P＜0.01） and negatively correlated with IAP and APACHE-Ⅱscore（r=-0.972 and-0.906,P＜0.01）.The largest area was observed under the curve of APP（94.5%）. Conclusion The mortality rate of SAP patients with a high IAH or an APP＜7.98kPa on admission is rather high.APP,as an independent index of prognosis of SAP patients,is advantageous over APACHE-Ⅱ score and IAP.