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Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study
Massimo Sartelli1, Fausto Catena, Luca Ansaloni
1Department of Surgery, Macerata Hospital, Macerata, Italy. m.sartelli@virgilio.it.
Insights
The CIAO study identified critical illness, healthcare-associated infections, and comorbidities as key risk factors for mortality in complicated intra-abdominal infections. Post-operative temperature and white blood cell counts also indicated patient mortality risk.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Surgical Infections
Background:
- Complicated intra-abdominal infections (IAIs) represent a significant global health challenge.
- Early identification of risk factors for mortality in IAIs is crucial for effective patient management.
- The CIAO Study aimed to investigate factors influencing outcomes in patients with IAIs.
Purpose of the Study:
- To report preliminary findings from the first half of the multicenter CIAO observational study.
- To identify risk factors associated with mortality in patients with complicated intra-abdominal infections.
- To analyze the impact of infection type (community-acquired vs. healthcare-associated) on patient outcomes.
Main Methods:
- A multicenter observational study involving 66 European medical institutions.
- Inclusion of patients with community-acquired or healthcare-associated complicated intra-abdominal infections.
- Data collection over a three-month period, with microbiological analysis of intraperitoneal specimens.
Main Results:
- 912 patients were enrolled, with 83.3% having community-acquired IAIs.
- The overall mortality rate was 6.4%.
- Significant mortality risk factors included critical illness on admission, healthcare-associated infections, generalized peritonitis, and comorbidities.
Conclusions:
- Critical clinical condition, healthcare-associated infections, and comorbidities are significant predictors of mortality in IAIs.
- Post-operative temperature and White Blood Cell (WBC) counts serve as indicators of patient mortality.
- These findings underscore the importance of early risk stratification and management in IAIs.
Abstract:
The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.
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