Clinical examination is an inaccurate predictor of intraabdominal pressure

Michael Sugrue*, Adrian Bauman, Felicity Jones, Gillian Bishop, Arthas Flabouris, Michael Parr, Anthony Stewart, Ken Hillman, Stephen A. Deane

*Corresponding author for this work

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

This study was designed to establish if clinical examination can accurately predict intraabdominal pressure (IAP). Between August 1998 and March 2000 a prospective blinded observational study of postoperative intensive care unit patients was undertaken at a major trauma center. IAP was measured using an intravesicular technique and compared with clinical evaluation. An IAP of at least 18 mmHg was considered elevated. The sensitivity, specificity, positive predicative value (ppv), negative predictive value (npv), kappa score, and reliability analysis were calculated. A total of 110 patients provided 150 estimates of IAP, which was elevated in 21%. The kappa score was 0.37; sensitivity, 60.9%; specificity, 80.5%; ppv, 45.2%; npv, 88.6%. The mean difference in IAP values between intravesicular readings and clinical estimates was -1.0 ± 4.1. Prediction of IAP using clinical examination is not accurate enough to replace intravesicular IAP measurements.

Original languageEnglish
Pages (from-to)1428-1431
Number of pages4
JournalWorld Journal of Surgery
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 2002
Externally publishedYes

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