Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis

Bruno Pereira; Alcir Dorigatti; Marina Melek; Jennifer dos Santos; Mayara Ferreira; Thiago Calderan; Cesar Carmona; Gustavo Fraga

doi:10.5114/ait.2019.88184

eISSN: 1731-2531
ISSN: 1642-5758

Anaesthesiology Intensive Therapy

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abstract:

Original paper

Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis

Bruno Monteiro Pereira

^{1, 2, 3}

,

Alcir Escocia Dorigatti

¹

,

Marina Zaponi Melek

⁴

,

Jennifer Leme dos Santos

⁵

,

Mayara Ferreira

⁶

,

Thiago Rodrigues Araujo Calderan

¹

,

Cesar Vanderlei Carmona

¹

,

Gustavo Pereira Fraga

¹

Division of Trauma, Department of Surgery, University of Campinas, Campinas, SP, Brazil
Grupo Surgical, Campinas, SP, Brazil
Campinas Holy House, Campinas, SP, Brazil
Emergency Medicine Department, School of Medicine, University of Campinas, Campinas, SP, Brazil
School of Medicine, University of Campinas, Campinas, SP, Brazil
PGY 1, General Surgery – Campinas Holy House, Campinas, SP, Brazil

Anaesthesiol Intensive Ther 2019; 51, 5: 370–372

DOI: https://doi.org/10.5114/ait.2019.88184

Online publish date: 2019/10/16

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AMA

Pereira BM, Dorigatti AE, Melek MZ, et al. Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis. Anaesthesiology Intensive Therapy. 2019;51(5):370-372. doi:10.5114/ait.2019.88184.

APA

Pereira, B. M., Dorigatti, A. E., Melek, M. Z., dos Santos, J. L., Ferreira, M.,  & Calderan, T. R. et al. (2019). Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis. Anaesthesiology Intensive Therapy, 51(5), 370-372. https://doi.org/10.5114/ait.2019.88184

Chicago

Pereira, Bruno M, Alcir E Dorigatti, Marina Z Melek, Jennifer L dos Santos, Mayara Ferreira, Thiago R Calderan,  and Cesar V Carmona et al. 2019. "Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis". Anaesthesiology Intensive Therapy 51 (5): 370-372. doi:10.5114/ait.2019.88184.

Harvard

Pereira, B., Dorigatti, A., Melek, M., dos Santos, J., Ferreira, M., Calderan, T., Carmona, C.,  and Fraga, G. (2019). Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis. Anaesthesiology Intensive Therapy, 51(5), pp.370-372. https://doi.org/10.5114/ait.2019.88184

MLA

Pereira, Bruno et al. "Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis." Anaesthesiology Intensive Therapy, vol. 51, no. 5, 2019, pp. 370-372. doi:10.5114/ait.2019.88184.

Vancouver

Pereira B, Dorigatti A, Melek M, dos Santos J, Ferreira M, Calderan T et al. Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis. Anaesthesiology Intensive Therapy. 2019;51(5):370-372. doi:10.5114/ait.2019.88184.

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Background
Intra-abdominal hypertension (IAH) is relatively frequent in critical patients. According to the most recent consensus of the World Society of Abdominal Compartment Society (WSACS), there are no predictive factors for IAH diagnosis. Risk factors are the only motivators to date for early IAH diagnosis. Abdominal compartment syndrome (ACS) is defined as sustained intra-abdominal pressure (IAP) maintained above 20 mm Hg (> 3 kPa), with or without abdominal perfusion pressure below 60 mm Hg (< 8 kPa), associated with a new organ dysfunction. Sepsis is a recognized cause of secondary ACS, but to date there is no correlation with admission SOFA (sequential organ failure assessment) score and ACS onset incidence. The objective of the present study is to determine the profile of extra-abdominal septic shock patients with IAH/ACS admitted to the intensive care unit (ICU) and correlating with admission SOFA score. Better understanding of this population may bring to light clinical predictive factors for IAH/ACS early diagnosis.

Methods
In this observational study IAH/ACS incidence was correlated with SOFA score calculated at ICU admission. The study enrolled all critically ill patients more than 18 years old admitted to the Medical Intensive Care Unit (MICU) of a university teaching hospital between April and October 2016, who had been diagnosed with extra-abdominal septic shock, according to the Surviving Sepsis Campaign and SEPSIS-3.

Results
Twenty-five patients were evaluated during 10 hospitalization days. The average age was 51.13 ± 16.52 years, and 64% of the patients were male. Most patients (76%) had pneumonia. On admission, the SOFA score was 6.54 ± 2.71. Mortality rate in the population studied was 52%. The incidence of IAH was 43.5%, while the incidence of ACS in the IAH population was 28%. SOFA admission score in patients with the diagnosis of ACS was of 8.42 ± 1.27. In this study SOFA score higher than 7 is correlated with IAH, with an accuracy of 68.8% (P < 0.03).

Conclusions
The incidence of ACS in patients with extra-abdominal septic shock admitted to a university teaching hospital MICU was higher than those found in the literature. Higher admission and consecutive SOFA score of more than 7 was associated with higher ACS incidence and higher mortality rate.

keywords:

Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome – a preliminary analysis

Bruno Monteiro Pereira 1, 2, 3 , Alcir Escocia Dorigatti 1 , Marina Zaponi Melek 4 , Jennifer Leme dos Santos 5 , Mayara Ferreira 6 , Thiago Rodrigues Araujo Calderan 1 , Cesar Vanderlei Carmona 1 , Gustavo Pereira Fraga 1

intra-abdominal hypertension, diagnosis, septic shock, sepsis, intensive care unit

Bruno Monteiro Pereira

^{1, 2, 3}

,

Alcir Escocia Dorigatti

¹

,

Marina Zaponi Melek

⁴

,

Jennifer Leme dos Santos

⁵

,

Mayara Ferreira

⁶

,

Thiago Rodrigues Araujo Calderan

¹

,

Cesar Vanderlei Carmona

¹

,

Gustavo Pereira Fraga

¹