Risk factors associated with intraabdominal infections: a prospective multicenter study. Peritonitis Study Group.

Area of Science:

• Surgical Infections
• Critical Care Medicine
• Clinical Epidemiology

Background:

• Peritonitis presents significant preoperative risk, therapeutic challenges, and variable patient outcomes.
• Existing scoring systems may not fully capture all critical prognostic factors.

Purpose of the Study:

• To assess preoperative risk, therapeutic management, and outcomes in patients with peritonitis.
• To identify factors influencing mortality and postoperative complications.
• To evaluate the role of specific microorganisms and their treatment on patient outcomes.

Main Methods:

• Prospective, observational, multicenter study involving 18 hospitals.
• Inclusion of 355 patients with macroscopically confirmed peritonitis.
• Standardized data collection and analysis including univariate and multivariate models (APACHE II).

Main Results:

• Univariate analysis identified age, comorbidities, peritonitis origin, admission type, and surgical success as significant factors.
• Multivariate analysis highlighted APACHE II score, successful operation, age, liver disease, malignant disease, and renal disease as predictors of death.
• Escherichia coli was the most common pathogen; inadequate enterococcal treatment correlated with higher infection rates.

Conclusions:

• Patient physiological reserve and surgeon's ability are crucial prognostic indicators not fully represented in current scoring systems.
• Further research is warranted to elucidate the impact of enterococci on peritonitis outcomes.
• Optimizing management strategies requires considering both patient-specific factors and surgical expertise.