Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)
World Journal of Emergency Surgery ,
Jan 2013
Massimo Sartelli , Fausto Catena , Luca Ansaloni , Ernest Moore , Mark Malangoni , George Velmahos , Raul Coimbra , Kaoru Koike , Ari Leppaniemi , Walter Biffl , et al.
Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18–98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients. The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.
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Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)
World Journal of Emergency Surgery
Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)
Massimo Sartelli 0
Fausto Catena
Luca Ansaloni
Ernest Moore
Mark Malangoni
George Velmahos
Raul Coimbra
Kaoru Koike
Ari Leppaniemi
Walter Biffl
Zsolt Balogh
Cino Bendinelli
Sanjay Gupta
Yoram Kluger
Ferdinando Agresta
Salomone Di Saverio
Gregorio Tugnoli
Elio Jovine
Carlos Ordonez
Carlos Augusto Gomes
Gerson Alves Pereira Junior
Kuo-Ching Yuan
Miklosh Bala
Miroslav P Peev
Yunfeng Cui
Sanjay Marwah
Sanoop Zachariah
Boris Sakakushev
Victor Kong
Adamu Ahmed
Ashraf Abbas
Ricardo Alessandro Teixeira Gonsaga
Gianluca Guercioni
Nereo Vettoretto
Elia Poiasina
Offir Ben-Ishay
Rafael Díaz-Nieto
Damien Massalou
Matej Skrovina
Ihor Gerych
Goran Augustin
Jakub Kenig
Vladimir Khokha
Cristian Tranà
Kenneth Yuh Yen Kok
Alain Chichom Mefire
Jae Gil Lee
Suk-Kyung Hong
Helmut Alfredo Segovia Lohse
Wagih Ghnnam
Alfredo Verni
Varut Lohsiriwat
Boonying Siribumrungwong
Alberto Tavares
Gianluca Baiocchi
Koray Das
Julien Jarry
Maurice Zida
Norio Sato
Kiyoshi Murata
Tomohisa Shoko
Takayuki Irahara
Ahmed O Hamedelneel
Noel Naidoo
Abdul Rashid Kayode Adesunkanmi
Yoshiro Kobe
AK Attri
Rajeev Sharma
Federico Coccolini
Tamer El Zalabany
Khalid Al Khalifa
Juan Sanjuan
Rita Barnabé
Wataru Ishii
0 Department of Surgery, Macerata Hospital , Macerata , Italy
Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18-98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients. The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.
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Introduction
Intra-abdominal infections (IAIs) include a wide spectrum
of pathological conditions, ranging from uncomplicated
appendicitis to fecal peritonitis [1].
From a clinical perspective, IAIs are classified in two
major categories: complicated and uncomplicated.
In uncomplicated IAIs, the infectious process only
involves a single organ and does not spread to the
peritoneum. Patients with such infections can be managed with
either surgical resection or antibiotics. When the focus of
infection is treated effectively by surgical excision, 24-hour
perioperative prophylaxis is typically sufficient. Patients
with less severe intra-abdominal infections, including
acute diverticulitis and certain forms of acute appendicitis,
may be treated non-operatively.
In complicated IAIs, the infectious process extends
beyond a singularly affected organ, and causes either
localized peritonitis or diffuse peritonitis. The treatment of
patients with complicated intra-abdominal infections
involves both source control and antibiotic therapy.
Intra-abdominal infections are further classified in two
groups: community-acquired intra-abdominal infections
(CA-IAIs) and healthcare-associated intra-abdominal
infections (HA-IAIs). CA-IAIs are acquired directly in the
community while HA-IAIs develop in hospitalized patients
or residents of long-term healthcare facilities. HA-IAIs are
associated with higher rates of mortality due to the
patients’ poorer underlying health and an increased
likelihood of infection by multi-drug resistant microorganisms.
Source control encompasses all measures undertaken
to eliminate the source of infection and to control
ongoing contamination.
The most common source of infection in
communityacquired intra-abdominal infections is the appendix,
followed by the colon, and then the stomach. Dehiscence
complicates 5-10% of intra-abdominal bowel anastomoses
and is associated with high rates of mortality [2].
Ultrasound- and CT-guided percutaneous drainage (...truncated)
This is a preview of a remote PDF: http://www.wjes.org/content/pdf/1749-7922-8-1.pdf
Massimo Sartelli, Fausto Catena, Luca Ansaloni, Ernest Moore, Mark Malangoni, George Velmahos, Raul Coimbra, Kaoru Koike, Ari Leppaniemi, Walter Biffl, Zsolt Balogh, Cino Bendinelli, Sanjay Gupta, Yoram Kluger, Ferdinando Agresta, Salomone Di Saverio, Gregorio Tugnoli, Elio Jovine, Carlos Ordonez, Carlos Augusto Gomes, Gerson Alves Pereira, Kuo-Ching Yuan, Miklosh Bala, Miroslav P Peev, Yunfeng Cui, Sanjay Marwah, Sanoop Zachariah, Boris Sakakushev, Victor Kong, Adamu Ahmed, Ashraf Abbas, Ricardo Alessandro Teixeira Gonsaga, Gianluca Guercioni, Nereo Vettoretto, Elia Poiasina, Offir Ben-Ishay, Rafael Díaz-Nieto, Damien Massalou, Matej Skrovina, Ihor Gerych, Goran Augustin, Jakub Kenig, Vladimir Khokha, Cristian Tranà, Kenneth Yuh Yen Kok, Alain Chichom Mefire, Jae Gil Lee, Suk-Kyung Hong, Helmut Alfredo Segovia Lohse, Wagih Ghnnam, Alfredo Verni, Varut Lohsiriwat, Boonying Siribumrungwong, Alberto Tavares, Gianluca Baiocchi, Koray Das, Julien Jarry, Maurice Zida, Norio Sato, Kiyoshi Murata, Tomohisa Shoko, Takayuki Irahara, Ahmed O Hamedelneel, Noel Naidoo, Abdul Rashid Kayode Adesunkanmi, Yoshiro Kobe, AK Attri, Rajeev Sharma, Federico Coccolini, Tamer El Zalabany, Khalid Al Khalifa, Juan Sanjuan, Rita Barnabé, Wataru Ishii.
Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study) ,
World Journal of Emergency Surgery,
2013, pp. 1, 8, DOI: 10.1186/1749-7922-8-1