Intra-abdominal Infection
Conditions
Keywords
complicated, intra-abdominal, infection, greek
Brief summary
Complicated Intra-Abdominal Infections (cIAIs) represent an emergent surgical situation which lead to important non trauma-related mortality in several Emergency Surgical Centers worldwide. Their prevalence seemed to be unrelated to age, gender, health status and socioeconomic condition. Early diagnosis, timely septic source control, wide-spectrum antibiotic delivery and resuscitation with fluids and vasoactive agents in critically ill patients are fundamentals for successful cIAIs management. Moreover, septic shock, antibiotic resistant multi-pathogens and comorbidities have been associated with increased morbidity and mortality of cIAIs. Several international health associations announce updated guidelines for cIAIs management. Nevertheless, such guidelines could not be widely implemented, because of specific features of several healthcare systems worldwide. The aim of the present study is to investigate the prevalence of cIAIs among the Greek health system and the potential association of time interval of septic source control, preoperative resuscitation and multidrug resistant pathogens with morbidity, mortality, ICU stay and length of stay in patients with cIAIs.
Detailed description
Registry of patients with complicated intra-abdominal infections including: * Patient demographics (gender, age, Carlson Comorbidity Index, cancer history/chemotherapy during the last 6 months, health unit stay during the last 6 months) * Management (conservative, minimally invasive, surgical) * Minimally invasive procedure - type (CT-guided drainage, endoscopic) * Surgical procedure - type (open or laparoscopic, day or night, procedure description) * Cultures (blood, peritoneal fluid, tissue) * Time of diagnosis (respiratory rate, heart rate, systolic blood pressure, lactate acid in blood gases, temperature, white cell count, CRP) * Just before procedure (respiratory rate, heart rate, systolic blood pressure, lactate acid in blood gases, vasoactive agent delivery, intubation) * Intraoperative parameters (time interval between diagnosis and intervention, WSES score, operative time, open abdomen, VAC) * After procedure (respiratory rate, heart rate, systolic blood pressure, lactate acid in blood gases, temperature, vasoactive agent delivery, intubation) * Empirical wide-spectrum antibiotics (type and time interval from diagnosis)
Interventions
None listed
Sponsors
Maximos Frountzas
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Inclusion criteria
1. Age ≥ 18 years old 2. Signed consent from patient or authorized representative 3. Complicated Intra-Abdominal Infection * Acute appendicitis with localized or diffuse peritonitis * Grade II or Grade III acute cholecystitis (Tokyo guidelines) * Visceral organ perforation with peritonitis * Bowel perforation after colonoscopy * Complicated diverticulitis (WSES classification) * Anastomotic leaks with abscess, localized or diffuse peritonitis
Exclusion criteria
1. Age \< 18 years old 2. No signed consent from patient or authorized representative
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Morbidity | 30 days | Overall complications due to complicated intra-abdominal infections |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Re-operation rate | 30 days | Re-operations after first surgical procedure |
| Multidrug resistant pathogen cultures | 30 days | Results of pathogen cultures indicating multi-drug resistant variants. |
| Organ failure | 30 days | Dysfunction of one ore more organs |
| Length of stay | 30 days | Days of hospitalization |
| Length of ICU stay | 30 days | Days in the ICU |
| Mortality | 30 days | Number of deaths due to complicated intra-abdominal infections |
Countries
Greece
Outcome results
None listed