Citation

Mbiine R, Alenyo R, Kobusingye OC, Kuteesa J, Nakanwagi C, Lekuya HM, Kituuka O, Galukande M. Int. J. Burns Trauma 2017; 7(6): 80-87.

Affiliation

Department of Surgery, College of Health Sciences, Makerere UniversityKampala, Uganda, East Africa.

Copyright

(Copyright © 2017, e-Century Publishing)

DOI

unavailable

PMID

29119060

Abstract

BACKGROUND: 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%.

Language: en

Keywords

Africa; Intra-abdominal hypertension; Uganda; abdominal compartment syndrome; mortality; outcome; severe burns; sub-Saharan Africa