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

被引：172

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：

WORLD JOURNAL OF EMERGENCY SURGERY | 2014年 / 9卷

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).

引用

页数：10