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

来源：

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS | 2022年 / 60卷 / 01期

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

页数：12

共 50 条

[21] Risk factors for mortality and cost implications of complicated intra-abdominal infections in critically ill patients
De Pascale, Gennaro
Carelli, Simone
Vallecoccia, Maria Sole
Cutuli, Salvatore Lucio
Taccheri, Temistocle
Montini, Luca
Bello, Giuseppe
Spanu, Teresa
Tumbarello, Mario
Cicchetti, Americo
Urbina, Irene
Oradei, Marco
Marchetti, Marco
Antonelli, Massimo
JOURNAL OF CRITICAL CARE, 2019, 50 : 169 - 176
[22] Risk factors for acute kidney injury in critically ill patients with complicated intra-abdominal infection
Suarez-de-La-Rica, Alejandro
Anillo, Victor
Montero, Ana
Hernandez-Gancedo, Carmen
Lopez-Tofino, Araceli
Gilsanz, Fernando
Maseda, Emilio
JOURNAL OF CRITICAL CARE, 2017, 38 : 104 - 108
[23] Sublingual microcirculation in patients with intra-abdominal hypertension: A pilot study in 15 critically ill patients
Maddison, Liivi
Karjagin, Juri
Buldakov, Maksim
Maell, Merilin
Kruusat, Rein
Lillemaee, Kadri
Kirsimaegi, Uelle
Starkopf, Joel
JOURNAL OF CRITICAL CARE, 2014, 29 (01) : 183.e1 - 183.e6
[24] Incidence and clinical effects of intra-abdominal hypertension in critically ill patients
Vidal, Maria Gabriela
Weisser, Javier Ruiz
Gonzalez, Francisco
Toro, Maria America
Loudet, Cecilia
Balasini, Carina
Canales, Hector
Reina, Rosa
Estenssoro, Elisa
CRITICAL CARE MEDICINE, 2008, 36 (06) : 1823 - 1831
[25] INTRA-ABDOMINAL HYPERTENSION IN MEDICAL CRITICALLY ILL PATIENTS: A NARRATIVE REVIEW
Ortiz-Diaz, Enrique
Lan, Charlie K.
SHOCK, 2014, 41 (03): : 175 - 180
[26] Intra-abdominal hypertensionand acute renal failurein critically ill patients
Dalfino, Lidia
Tullo, Livio
Donadio, Ilaria
Malcangi, Vincenzo
Brienza, Nicola
INTENSIVE CARE MEDICINE, 2008, 34 (04) : 707 - 713
[27] CHARACTERIZATION OF VANCOMYCIN USE FOR INTRA-ABDOMINAL INFECTIONS IN CRITICALLY ILL PATIENTS
Volles, David
Tan, Josephine
Cox-Hall, Heather
CRITICAL CARE MEDICINE, 2020, 48
[28] Intra-abdominal hypertensionand acute renal failurein critically ill patients
Lidia Dalfino
Livio Tullo
Ilaria Donadio
Vincenzo Malcangi
Nicola Brienza
Intensive Care Medicine, 2008, 34 : 707 - 713
[29] Results of the international survey on clinical awareness of intra-abdominal hypertension and abdominal compartment syndrome in critically ill patients (WSACS study 003)
Malbrain, M. L. N. G.
Cheatham, M.
ACTA CLINICA BELGICA, 2007, 62 : 247 - 248
[30] PROGNOSTIC FACTORS IN PATIENTS WITH INTRA-ABDOMINAL INFECTION AND SEVERE SEPSIS
Zoric, L.
Pallancher, S.
Lefrant, J. Y.
INTENSIVE CARE MEDICINE, 2009, 35 : 192 - 192

← 1 2 3 4 5 →