5 research outputs found
Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study
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110654.pdf (Publisher’s version ) (Open Access)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 degrees C or less than 36 degrees C by the third post-operative day were statistically significant indicators of patient mortality
Complicated intra-abdominal infections in Europe: a comprehensive review of the {CIAO} study
No full textThe CIAO Study (``Complicated Intra-Abdominal infection
Observational'' Study) is a multicenter investigation performed
in 68 medical institutions throughout Europe over the course of
a 6-month observational period (January-June 2012).Patients with
either community-acquired or healthcare-associated complicated
intra-abdominal infections (IAIs) were included in the
study.2,152 patients with a mean age of 53.8 years (range: 4-98
years) were enrolled in the study. 46.3\% of the patients were
women and 53.7\% were men. Intraperitoneal specimens were
collected from 62.2\% of the enrolled patients, and from these
samples, a variety of microorganisms were collectively
identified.The overall mortality rate was 7.5\%
(163/2.152).According to multivariate analysis of the compiled
data, several criteria were found to be independent variables
predictive of patient mortality, including patient age, the
presence of an intestinal non-appendicular source of infection
(colonic non-diverticular perforation, complicated
diverticulitis, small bowel perforation), a delayed initial
intervention (a delay exceeding 24 hours), sepsis and septic
shock in the immediate post-operative period, and ICU
admission.Given the sweeping geographical distribution of the
participating medical centers, the CIAO Study gives an accurate
description of the epidemiological, clinical, microbiological,
and treatment profiles of complicated intra-abdominal infections
(IAIs) throughout Europe
Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study
No full textThe CIAO Study ("Complicated Intra-Abdominal infection Observational" Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012).Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.2,152 patients with a mean age of 53.8 years (range: 4-98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified.The overall mortality rate was 7.5% (163/2.152).According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission.Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe
Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study
No full textBackground:The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.Methods:LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).Results:A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.Conclusions:This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives
