Related Experiment Video
Updated: Sep 22, 2025
Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
Time to source control and outcome in community-acquired intra-abdominal infections: The multicentre observational
Claire Roger1, Delphine Garrigue, Guillaume Bouhours
1From the Division of Anaesthesiology, Intensive Care, Pain and Emergency Medicine, Department of Intensive Care Medicine, Nîmes University Hospital, Nîmes (CR, SL, BL), Equipe d'accueil 2992 Caractéristiques Féminines des Interfaces Vasculaires (IMAGINE), Faculté de médecine, Univ Montpellier, Montpellier (CR, BL), Department of Anesthesiology and Critical Care, Centre Hospitalier Universitaire Lille, Surgical Critical Care, F-59000 Lille (DG), Department of Anaesthesiology and Intensive Care, UNAM University, University of Angers, Angers University Hospital, 49933 Angers (GB), Department of Anesthesia and Critical Care Medicine, Centre Hospitalier Universitaire Amiens Picardie and SSPC Research Unit, Université de Picardie Jules Verne, Amiens (HD), Université Grenoble Alpes, Pôle Anesthésie-Réanimation, Centre Hospitalo-Universitaire Grenoble-Alpes, Grenoble (PB), Service d'anesthésie et des réanimations chirurgicales, Unité de réanimation chirurgicale et neuro-traumatologique, Assistance Publique - Hôpitaux de Paris, Hôpitaux universitaires Henri Mondor, 94000 Créteil (JB), Pôle d'Anesthésie-Réanimation & Médecine Péri-Opératoire, Service d'Anesthésie-Réanimation & Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France - EA3072, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de Médecine, Université de Strasbourg, Strasbourg (JP), Université de Paris, INSERM U1152, ANR-10-LABX-17, CHU Bichat-Claude Bernard, APHP, Paris (PM), Département de Médecine d'Urgence, Hôpital de la Timone - AP-HM, Aix Marseille Université, UMR 1263 C2VN, Marseille (PM), CHU Estaing, University of Auvergne, Clermont-Ferrand (SP), Service d'Accueil des Urgences, Hôpital d'Instruction des Armées Percy, Clamart (KA), Hospices Civils de Lyon, centre hospitalier Lyon Sud, service d'Anesthésie-Réanimation, Lyon (PI) and Department of Anaesthesiology and Critical Care, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Saclay, Le Kremlin Bicêtre, France (AH).
Background:
Optimal management of community-acquired intra-abdominal infections (IAI) requires timely surgical source control and adequate anti-infective treatment.
Objective:
To describe the initial management of community-acquired IAI admitted to the emergency department and assess the association between the length of time to either diagnosis or therapeutic procedures and patient outcomes.
Design:
A prospective, multicentre, observational study.
Setting:
Thirteen teaching hospitals in France between April 2018 and February 2019.
Patients:
Two hundred and five patients aged at least 18 years diagnosed with community-acquired IAI.
Main Outcome Measures:
The primary outcome was hospital length of stay. The secondary outcome was hospital mortality.
Results:
Patients had a mean age of 56 (± 21) years and a median [interquartile] SAPS II of 26 [17 to 34]. Among the study cohort, 18% were postoperatively transferred to intensive care unit and 7% had died by day 28. Median [IQR] time to imaging, antibiotic therapy and surgery were 4 [2 to 6], 7.5 [4 to 12.5] and 9 [5.5 to 17] hours, respectively. The length of time to surgical source control [0.99, 95% confidence interval (CI), 0.98 to 0.99], SOFA greater than 2 [0.36 (95% CI, 0.26 to 0.651)], age greater than 60 years [0.65 (95% CI, 0.45 to 0.94)], generalized peritonitis [0.7 (95% CI, 0.56 to 0.89)] and laparotomy surgery [0.657 (95% CI, 0.42 to 0.78)] were associated with longer hospital length of stay. The duration of time to surgical source control [1.02 (95% CI, 1.01 to 1.04)], generalized peritonitis [2.41 (95% CI, 1.27 to 4.61)], and SOFA score greater than 2 [6.14 (95% CI, 1.40 to 26.88)] were identified as independent risk factors for 28-day mortality.
Conclusion:
This multicentre observational study revealed that the time to surgical source control, patient severity and generalized peritonitis were identified as independent risk factors for increased hospital LOS and mortality in community-acquired IAI. Organisational strategies to reduce the time to surgical management of intra-abdominal infections should be further evaluated.
Study Registration:
ClinicalTrials.gov on 1 April 2018, NCT03544203.
More Related Videos
04:01Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
Published on: September 8, 2022
03:47A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.