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Table 4 Significant risk factors for intra-abdominal hypertension among intensive care unit patients, including pooled estimates where appropriate

From: Risk factors for intra-abdominal hypertension and abdominal compartment syndrome among adult intensive care unit patients: a systematic review and meta-analysis

Risk factor

Systematic review and/or meta-analysis

Number

Patient population

Odds ratio (95% CI)

Heterogeneity

Studies

Patients

I2, %

P value

Demographics

Obesity [1, 15, 18, 19]

4

909

Mixed ICU patients

5.10 (1.92 to 13.58)

60.2

0.06

Age (per year increase) [9]

1

123

Mixed ICU patients

2.75 (1.01 to 3.09)

  

Presenting diagnosis

Sepsis [9, 19]

2

223

Mixed ICU patients

2.38 (1.34 to 4.23)

0.0

0.47

Abdominal infection [2, 19]

2

183

Mixed ICU patients

2.49 (0.48 to 13.0)

82.7

0.02

Abdominal surgery [2, 9, 15, 24]

4

1034

Mixed ICU patients

1.93 (1.30 to 2.85)

57.1

0.07

Post-laparotomy [17]

1

81

Trauma patients

5.72 (1.50 to 21.43)

  

Pancreatitis [15]

1

563

Mechanically ventilated mixed ICU patients

4.73 (1.96 to 11.41)

  

Hepatic failure/cirrhosis [15]

1

563

Mechanically ventilated mixed ICU patients

2.07 (2.07 to 28.81)

  

GI bleeding [15]

1

563

Mechanically ventilated mixed ICU patients

3.37 (1.43 to 7.94)

  

Ileus [2, 24]

2

348

Mixed ICU patients

2.05 (1.40 to 2.98)

0.0

0.96

Liver dysfunction [24]†

1

265

Mixed ICU patients

2.25 (1.1 to 4.58)

  

Disease severity

APACHE II score (per point increase) [10]

1

58

Pancreatitis patients

1.652 (1.131 to 2.414)*

  

Metabolic derangement/organ failure

Base deficit [17]

1

81

Trauma patients

1.15 (1.01 to 1.33)

  

Acidosis [2]†

1

83

Mixed ICU patients

1.93 (1.12 to 3.45)

  

Shock/hypotension

Vasopressor use [15]

1

563

Mechanically ventilated mixed ICU patients

2.33 (1.02 to 5.35)

  

Shock [9]

1

123

Mixed ICU patients

4.68 (1.93 to 6.44)

  

Hypotension [2]†

1

83

Mixed ICU patients

2.12 (1.05 to 4.50)

  

CVP (per mmHg) [19]

1

100

Mixed ICU patients

1.3 (1.1 to 1.6)

  

Respiratory status/failure

PEEP >10cm H20 [15]

1

563

Mechanically ventilated mixed ICU patients

2.41 (1.57 to 3.70)

  

Respiratory failure [15]

1

563

Mechanically ventilated mixed ICU patients

1.87 (1.22 to 2.87)

  

ARDS [2]

1

83

Mixed ICU patients

3.61 (1.60 to 9.06)

  

Mechanical ventilation [2]

1

83

Mixed ICU patients

6.78 (1.94 to 59.03)

  

Crystalloid resuscitation

Pre-ICU crystalloid [17]†,‡

1

81

Trauma patients

1.40 (1.00 to 1.96)

  

Fluid balance [9]†,‡

1

563

Mixed ICU patients

5.22 (2.03 to 7.45)

  

24hr fluid balance [10]†,‡

1

58

Pancreatitis patients

1.004 (1.001 to 1.006)*

  

Fluid collections [10]†

1

58

Pancreatitis patients

2.015 (1.298 to 3.129)*

  

Non-crystalloid resuscitation

Fluid resuscitation (>3.5 L crystalloid or colloid) [1, 24]

2

362

Mixed ICU patients

2.17 (1.30 to 3.63)

0.0

0.35

  1. *Unadjusted; †indicative of a risk factor that was not clearly defined; ‡although the odds ratio in these studies appeared to increase per liter of fluid, this was unclear in the manuscript. Where abdominal infection was defined as infection of the peritoneal cavity confirmed by radiology or microbiology [19], or pancreatitis, abscess, or other [2]; sepsis was defined according to consensus definitions [9, 19]; and respiratory failure was defined as PaO2/FiO2 <300 mmHg [15]. APACHE II, acute physiology and chronic health evaluation II, CVP, central venous pressure; PEEP, positive end-expiratory pressure; ARDS, acute respiratory distress syndrome.
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