Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study

被引:164
|
作者
Sartelli, Massimo [1 ]
Catena, Fausto [2 ]
Ansaloni, Luca [3 ]
Coccolini, Federico [3 ]
Corbella, Davide [4 ]
Moore, Ernest E. [5 ]
Malangoni, Mark [6 ]
Velmahos, George [7 ]
Coimbra, Raul [8 ]
Koike, Kaoru [9 ]
Leppaniemi, Ari [10 ]
Biffl, Walter [5 ]
Balogh, Zsolt [11 ]
Bendinelli, Cino [11 ]
Gupta, Sanjay [12 ]
Kluger, Yoram [13 ]
Agresta, Ferdinando [14 ]
Di Saverio, Salomone [15 ]
Tugnoli, Gregorio [15 ]
Jovine, Elio [16 ]
Ordonez, Carlos A. [17 ]
Whelan, James F. [18 ]
Fraga, Gustavo P. [19 ]
Gomes, Carlos Augusto [20 ]
Pereira Junior, Gerson Alves [21 ]
Yuan, Kuo-Ching [22 ]
Bala, Miklosh [23 ]
Peev, Miroslav P. [7 ]
Ben-Ishay, Offir [13 ]
Cui, Yunfeng [24 ]
Marwah, Sanjay [25 ]
Zachariah, Sanoop [26 ]
Wani, Imtiaz [27 ]
Rangarajan, Muthukumaran [28 ]
Sakakushev, Boris [29 ]
Kong, Victor [30 ]
Ahmed, Adamu [31 ]
Abbas, Ashraf [32 ]
Teixeira Gonsaga, Ricardo Alessandro [33 ]
Guercioni, Gianluca [34 ]
Vettoretto, Nereo [35 ]
Poiasina, Elia [3 ]
Diaz-Nieto, Rafael [36 ]
Massalou, Damien [37 ]
Skrovina, Matej [38 ]
Gerych, Ihor [39 ]
Augustin, Goran [40 ]
Kenig, Jakub [41 ]
Khokha, Vladimir [42 ]
Trana, Cristian [43 ]
机构
[1] Macerata Hosp, Dept Surg, Macerata, Italy
[2] Maggiore Parma Hosp, Parma, Italy
[3] Osped Riuniti Bergamo, Dept Gen Surg, I-24100 Bergamo, Italy
[4] Osped Riuniti Bergamo, Dept Anestesiol, I-24100 Bergamo, Italy
[5] Denver Hlth Med Ctr, Dept Surg, Denver, CO USA
[6] Amer Board Surg, Philadelphia, PA USA
[7] Harvard Univ, Sch Med, Div Trauma Emergency Surg & Surg Crit Care, Cambridge, MA 02138 USA
[8] UC San Diego Hlth Syst, Dept Surg, San Diego, CA USA
[9] Kyoto Univ, Grad Sch Med, Dept Primary Care & Emergency Med, Kyoto, Japan
[10] Univ Hosp Meilahti, Dept Abdominal Surg, Helsinki, Finland
[11] Univ Newcastle, Dept Surg, Newcastle, NSW 2300, Australia
[12] Govt Med Coll & Hosp, Dept Surg, Chandigarh, India
[13] Rambam Hlth Care Campus, Dept Gen Surg, Haifa, Israel
[14] Adria Hosp Adria, Dept Surg, Adria, Italy
[15] Maggiore Hosp, Trauma Surg Unit, Bologna, Italy
[16] Maggiore Hosp, Dept Surg, Bologna, Italy
[17] Fdn Valle Lili, Dept Surg, Cali, Colombia
[18] Virginia Commonwealth Univ, Dept Surg, Div Trauma, Crit Care Dept, Richmond, VA USA
[19] Univ Estadual Campinas, Div Trauma Surg, Campinas, SP, Brazil
[20] Mt Sinai Hosp, Dept Surg, Juiz De Fora, Brazil
[21] Dept Surg, Emergency Unit, Ribeirao Preto, Brazil
[22] Chang Gung Mem Hosp, Dept Surg, Taoyuan, Taiwan
[23] Hadassah Med Ctr, Dept Gen Surg, IL-91120 Jerusalem, Israel
[24] Tianjin Med Univ, Tianjin Nankai Hosp, Dept Surg, Nankai Clin Sch Med, Tianjin, Peoples R China
[25] Pt BDS Postgrad Inst Med Sci, Dept Surg, Rohtak, Haryana, India
[26] MOSC Med Coll, Dept Surg, Cochin, Kerala, India
[27] SKIMS, Dept Surg, Srinagar, Jammu & Kashmir, India
[28] Kovai Med Ctr, Dept Surg, Coimbatore, Tamil Nadu, India
[29] Univ Hosp UMBAL St George Plovdiv, Clin Gen Surg 1, Plovdiv, Bulgaria
[30] Edendale Surg, Dept Surg, Pietermaritzburg, South Africa
[31] Ahmadu Bello Univ, Dept Surg, Teaching Hosp Zaria, Kaduna, Nigeria
[32] Mansoura Univ Hosp, Dept Surg, Mansoura, Egypt
[33] Fac Integradas Padre Albino, Dept Surg, Catanduva, Brazil
[34] Mazzoni Hosp, Dept Surg, Ascoli Piceno, Italy
[35] Mellini Hosp, Dept Surg, Chiari, BS, Italy
[36] Univ Hosp, Dept Gen & Digest Surg, Malaga, Spain
[37] Univ Nice Sophia Antipolis, Univ Hosp Nice, Dept Gen Surg & Surg Oncol, F-06189 Nice, France
[38] Hosp & Oncol Ctr, Dept Surg, Novy Jicin, Czech Republic
[39] Lviv Emergency Hosp, Dept Gen Surg, Lvov, Ukraine
[40] Univ Hosp Ctr Zagreb, Dept Surg, Zagreb, Croatia
[41] Jagiellonian Univ, Narutowicz Hosp, Dept Gen Surger 3, Krakow, Poland
[42] Mozyr City Hosp, Dept Surg, Mozyr, BELARUS
[43] Univ Ancona, Dept Surg, Ancona, Italy
[44] Ripas Hosp, Dept Surg, Bandar Seri Begawan, Brunei
[45] Reg Hosp Limbe & Buea, Limbe, Cameroon
[46] Yonsei Univ, Coll Med, Severance Hosp, Dept Surg, Seoul, South Korea
[47] Univ Ulsan, Dept Surg, Div Trauma & Surg Crit Care, Seoul, South Korea
[48] Hosp Clin, Catedra Clin Quirurg 2, Asuncion, Paraguay
[49] Cutral Co Clin, Dept Surg, Cutral Co, Argentina
[50] Siriraj Hosp, Fac Med, Dept Surg, Bangkok, Thailand
来源
关键词
KLEBSIELLA-PNEUMONIAE; APPENDICEAL ABSCESS; ACUTE CHOLECYSTITIS; SEVERE PERITONITIS; MANAGEMENT; CHOLECYSTECTOMY; RELAPAROTOMY; SEPSIS; EUROPE;
D O I
10.1186/1749-7922-9-37
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001).
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