Epidemiology and age-related mortality in critically ill patients with intra-abdominal infection or sepsis: an international cohort study

被引:26
|
作者
Arvaniti, Kostoula [1 ]
Dimopoulos, George [2 ]
Antonelli, Massimo [3 ,4 ]
Blot, Koen [5 ]
Creagh-Brown, Ben [6 ,7 ]
Deschepper, Mieke [8 ]
de Lange, Dylan [9 ]
De Waele, Jan [10 ]
Dikmen, Yalim [11 ]
Eckmann, Christian [12 ]
Einav, Sharon [13 ,14 ]
Francois, Guy [15 ]
Fjeldsoee-Nielsen, Hans [16 ]
Girardis, Massimo [17 ]
Jovanovic, Bojan [18 ]
Lindner, Matthias [19 ]
Koulenti, Despoina [20 ,21 ]
Labeau, Sonia [5 ,22 ]
Lipman, Jeffrey [23 ,24 ]
Lipovestky, Fernando [25 ]
Makikado, Luis Daniel Umezawa [26 ]
Maseda, Emilio [27 ]
Mikstacki, Adam [28 ,29 ]
Montravers, Philippe [30 ,31 ]
Paiva, Jose Artur [32 ]
Pereyra, Cecilia [33 ]
Rello, Jordi [34 ]
Timsit, Jean-Francois [35 ,36 ]
Tomescu, Dana [37 ,38 ]
Vogelaers, Dirk [5 ,39 ]
Blot, Stijn [5 ,40 ]
机构
[1] Papageorgiou Univ, Intens Care Unit, Affiliated Hosp, Thessaloniki, Greece
[2] Natl & Kapodistrian Univ Athens, Univ Hosp Attikon, Crit Care Dept, Athens, Greece
[3] Fdn Policlin Univ A Gemelli IRCCS, Dept Anaesthesiol Intens Care & Emergency Med, Rome, Italy
[4] Univ Cattolica Sacro Cuore, Rome, Italy
[5] Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
[6] Royal Surrey Cty Hosp, Surrey Perioperat Anaesthet Crit Care Collaborat R, Guildford, England
[7] Univ Surrey, Dept Clin & Expt Med, Guildford, England
[8] Ghent Univ Hosp, Strateg Policy Cell, Ghent, Belgium
[9] Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands
[10] Univ Queensland, Dept Crit Care Med, Brisbane, Australia
[11] Hop Bichat Claude Bernard, Med & Infect Dis ICU MI2, Dept Anaesthesiol & Reanimat, Paris, France
[12] Goettingen Univ, Dept Gen Visceral & Thorac Surg, Klinikum Hannoversch Muenden, Gottingen, Germany
[13] Shaare Zedek Med Ctr, Gen Intens Care Unit, Jerusalem, Israel
[14] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel
[15] European Soc Intens Care Med, Div Sci Affairs Res, Brussels, Belgium
[16] Nykoebing Falster Hosp, Dept Anaesthesiol & Intens Care, Nykoebing Falster, Denmark
[17] Univ Hosp Modena, Anaesthesia & Intens Care Dept, Modena, Italy
[18] Univ Belgrade, Fac Med, Ctr Anaesthesia & Resuscitat, Clin Ctr Serbia, Belgrade, Serbia
[19] Univ Med Ctr Schleswig Holstein, Dept Anaesthesiol & Intens Care Med, Campus Kiel, Kiel, Germany
[20] Univ Queensland, Fac Med, Burns Trauma & Crit Care Res Ctr, Ctr Clin Res, Brisbane, Australia
[21] Attikon Univ Hosp, Crit Care Dept 2, Athens, Greece
[22] Univ Coll Ghent, Fac Educ Hlth & Social Work, Dept Nursing, Ghent, Belgium
[23] Jamieson Trauma Inst, Brisbane, Australia
[24] Univ Montpellier, Nimes Univ Hosp, Nimes, France
[25] Hosp Interamer Open Univ, Crit Care Dept, Buenos Aires, Argentina
[26] Clin Ricardo Palma, Unidad Cuidados Intens, Lima, Peru
[27] Hosp Univ La Paz IdiPaz, Dept Anaesthesia, Surg Crit Care, Madrid, Spain
[28] Poznan Univ Med Sci, Fac Hlth Sci, Poznan, Poland
[29] Reg Hosp Poznan, Dept Anaesthesiol & Intens Therapy, Poznan, Poland
[30] Univ Paris, NSERM UMR 1152, ANR10 LABX 17, Paris, France
[31] Hop Bichat Claude Bernard, AP HP, Dept Anaesthesiol & Crit Care Med, Paris, France
[32] Univ Porto, Ctr Hosp Univ S Joao, Fac Med, Intens Care Dept, Porto, Portugal
[33] Hosp Interzonal Gen Agudos Prof Dr Luis Guemes, Intens Care Unit, Buenos Aires, Argentina
[34] Ciberes & Vall dHebron Inst Res, Barcelona, Spain
[35] Univ Paris, IAME, INSERM, Paris, France
[36] AP HP, Paris, France
[37] Fundeni Clin Inst, Dept Anaesthesia & Crit Care, Bucharest, Romania
[38] Carol Davila Univ Med & Pharm, Bucharest, Romania
[39] AZ Delta, Dept Gen Internal Med & Infect Dis, Roeselare, Belgium
[40] Univ Ghent, Dept Internal Med & Paediat, Campus UZ Gent,Corneel Heymanslaan 10, B-9000 Ghent, Belgium
关键词
Intra-abdominal infection; Sepsis; Older adults; ICU; Mortality; BLOOD-STREAM INFECTIONS; LONG-TERM MORTALITY; ELDERLY-PATIENTS; RISK-FACTORS; CARE; PERITONITIS; DEFINITIONS; PREVALENCE; MANAGEMENT; IMPACT;
D O I
10.1016/j.ijantimicag.2022.106591
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objective: To describe epidemiology and age-related mortality in critically ill older adults with intraabdominal infection.Methods: A secondary analysis was undertaken of a prospective, multi-national, observational study (Abdominal Sepsis Study, ClinicalTrials.gov #NCT03270345) including patients with intra-abdominal infection from 309 intensive care units (ICUs) in 42 countries between January and December 2016. Mortality was considered as ICU mortality, with a minimum of 28 days of observation when patients were discharged earlier. Relationships with mortality were assessed by logistic regression analysis.Results: The cohort included 2337 patients. Four age groups were defined: middle-aged patients [reference category; 40-59 years; n = 659 (28.2%)], young-old patients [60-69 years; n = 622 (26.6%)], middle old patients [70-79 years; n = 667 (28.5%)] and very old patients [ >80 years; n = 389 (16.6%)]. Secondary peritonitis was the predominant infection (68.7%) and was equally prevalent across age groups. Mortality increased with age: 20.9% in middle-aged patients, 30.5% in young-old patients, 31.2% in middle-old patients, and 44.7% in very old patients ( P < 0.001). Compared with middle-aged patients, young-old age [odds ratio (OR) 1.62, 95% confidence interval (CI) 1.21-2.17], middle-old age (OR 1.80, 95% CI 1.35-2.41) and very old age (OR 3.69, 95% CI 2.66-5.12) were independently associated with mortality. Other independent risk factors for mortality included late-onset hospital-acquired intra-abdominal infection, diffuse peritonitis, sepsis/septic shock, source control failure, liver disease, congestive heart failure, diabetes and malnutrition.Conclusions: For ICU patients with intra-abdominal infection, age > 60 years was associated with mortality; patients aged >80 years had the worst prognosis. Comorbidities and overall disease severity further compromised survival. As all of these factors are non-modifiable, it remains unclear how to improve outcomes.(c) 2022 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
引用
收藏
页数:12
相关论文
共 50 条
  • [1] The Epidemiology of Intra-Abdominal Flora in Critically Ill Patients with Secondary and Tertiary Abdominal Sepsis
    J. de Ruiter
    J. Weel
    E. Manusama
    W. P. Kingma
    P. H. J. van der Voort
    Infection, 2009, 37 : 522 - 527
  • [2] Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
    Stijn Blot
    Massimo Antonelli
    Kostoula Arvaniti
    Koen Blot
    Ben Creagh-Brown
    Dylan de Lange
    Jan De Waele
    Mieke Deschepper
    Yalim Dikmen
    George Dimopoulos
    Christian Eckmann
    Guy Francois
    Massimo Girardis
    Despoina Koulenti
    Sonia Labeau
    Jeffrey Lipman
    Fernando Lipovestky
    Emilio Maseda
    Philippe Montravers
    Adam Mikstacki
    José-Artur Paiva
    Cecilia Pereyra
    Jordi Rello
    Jean-Francois Timsit
    Dirk Vogelaers
    Intensive Care Medicine, 2019, 45 : 1703 - 1717
  • [3] Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project
    Blot, Stijn
    Antonelli, Massimo
    Arvaniti, Kostoula
    Blot, Koen
    Creagh-Brown, Ben
    de Lange, Dylan
    De Waele, Jan
    Deschepper, Mieke
    Dikmen, Yalim
    Dimopoulos, George
    Eckmann, Christian
    Francois, Guy
    Girardis, Massimo
    Koulenti, Despoina
    Labeau, Sonia
    Lipman, Jeffrey
    Lipovestky, Fernando
    Maseda, Emilio
    Montravers, Philippe
    Mikstacki, Adam
    Paiva, Jose-Artur
    Pereyra, Cecilia
    Rello, Jordi
    Timsit, Jean-Francois
    Vogelaers, Dirk
    Lamrous, Amin
    Rezende-Neto, Joao
    Cardenas, Yenny
    Vymazal, Tomas
    Fjeldsoee-Nielsen, Hans
    Kott, Matthias
    Kostoula, Arvaniti
    Javeri, Yash
    Einav, Sharon
    Umezawa Makikado, Luis Daniel
    Tomescu, Dana
    Gritsan, Alexey
    Jovanovic, Bojan
    Venkatesan, Kumaresh
    Mirkovic, Tomislav
    Creagh-Brown, Benedict
    Emmerich, Monica
    Canale, Mariana
    Silvina Dietz, Lorena
    Ilutovich, Santiago
    Sanchez Minope, John Thomas
    Baldomera Silva, Ramona
    Alexis Montenegro, Martin
    Martin, Patricio
    Saul, Pablo
    INTENSIVE CARE MEDICINE, 2019, 45 (12) : 1703 - 1717
  • [4] Intra-abdominal pressure and intra-abdominal hypertension in critically ill obstetric patients: a prospective cohort study
    Tyagi, A.
    Singh, S.
    Kumar, M.
    Sethi, A. K.
    INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 2017, 32 : 33 - 40
  • [5] Epidemiology and outcomes of source control procedures in critically ill patients with intra-abdominal infection
    van de Groep, Kirsten
    Verhoeff, Tessa L.
    Verboom, Diana M.
    Bos, Lieuwe D.
    Schultz, Marcus J.
    Bonten, Marc J. M.
    Cremer, Olaf L.
    de Beer, Friso M.
    Bos, Lieuwe D. J.
    Glas, Genie J.
    Hoogendijk, Arie J.
    van Hooijdonk, Roosmarijn T. M.
    Horn, Janneke
    Huson, Mischa A.
    Juffermans, Nicole P.
    van der Poll, Tom
    Schouten, Laura R. A.
    Scicluna, Brendon
    Wiewel, Maryse A.
    Witteveen, Esther
    Frencken, Jos F.
    Klouwenberg, M. C. Klein
    Koster-Brouwer, Maria E.
    Ong, David S. Y.
    Varkila, Med R. J.
    JOURNAL OF CRITICAL CARE, 2019, 52 : 258 - 264
  • [6] Can Intra-abdominal Pressure Predict the Pharmacokinetics of Aminoglycosides in Critically Ill Patients With Intra-abdominal Sepsis?
    Shahrami, Bita
    Arabzadeh, Amir Ahmad
    Najmeddin, Farhad
    Sefidani Forough, Aida
    Najafi, Atabak
    Rouini, Mohammad Reza
    Mojtahedzadeh, Mojtaba
    AMERICAN JOURNAL OF THERAPEUTICS, 2022, 29 (03) : E376 - E378
  • [7] ANTIFUNGAL USE IN CRITICALLY ILL PATIENTS WITH INTRA-ABDOMINAL INFECTION
    Agustin, Janelle
    CRITICAL CARE MEDICINE, 2023, 51 (01) : 174 - 174
  • [8] Evaluation of Amikacin Pharmacokinetics in Critically Ill Patients with Intra-abdominal Sepsis
    Shahrami, Bita
    Najmeddin, Farhad
    Rouini, Mohammad Reza
    Najafi, Atabak
    Sadeghi, Kourosh
    Amini, Shahideh
    Khezrnia, Seyedeh Sana
    Sharifnia, Hamid Reza
    Mojtahedzadeh, Mojtaba
    ADVANCED PHARMACEUTICAL BULLETIN, 2020, 10 (01) : 114 - 118
  • [9] Impact of sarcopenic obesity on 30-day mortality in critically ill patients with intra-abdominal sepsis
    Ji, Yun
    Cheng, Baoli
    Xu, Zhipeng
    Ye, Hui
    Lu, Weina
    Luo, Xiaoqian
    Fu, Shuiqiao
    Fang, Xiangming
    JOURNAL OF CRITICAL CARE, 2018, 46 : 50 - 54
  • [10] The Epidemiology of Intra-Abdominal Flora in Critically III Patients with Secondary and Tertiary Abdominal Sepsis
    de Ruiter, J.
    Weel, J.
    Manusama, E.
    Kingma, W. P.
    van der Voort, P. H. J.
    INFECTION, 2009, 37 (06) : 522 - 527