Prediction of abdominal compartment syndrome in patients with severe acute pancreatitis

Aim: To identify factors associated with the risk of developing abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP).

Materials and Methods: A retrospective single-center cohort study of 106 patients with SAP, complicated by ACS (n=32) and without the given complication (n=74). The first stage included an intergroup comparison of 28 clinical-laboratory indicators recorded during the early stages of the disease. The second and third stages consisted of univariate and multivariate logistic regression analyses of the variables selected over the first stage, developing a prediction model, and evaluating its characteristics.

Results: Statistically significant difference between the groups was found for the following 14 indicators: BMI, Glasgow Coma Scale score, visceral obesity index, CRP level, radiological signs of paresis, pleural effusion, fluid collections in the retroperitoneal space, daily fluid balance, pain intensity according to the NPRS scale, the total score on the Marshall and BISAP scales, early persistent SIRS, APP and RFG levels (p<0.05). The given factors were identified as independent risk factors for ACS development: daily fluid balance, pain intensity (NPRS), retroperitoneal fluid collections, early persistent SIRS, and elevated WHR. The developed logistic model demonstrated high discriminatory ability: AUC = 0.92, sensitivity - 94%, specificity - 81%.

Conclusions: The developed model can enable patient stratification and targeted correction of potentially modifiable ACS risk factors in the early stages of SAP.