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Comparative Study
. 2020 Dec 1;20(1):295.
doi: 10.1186/s12871-020-01209-1.

Outcome of community- versus hospital-acquired intra-abdominal infections in intensive care unit: a retrospective study

Timothée Abaziou  1 , Fanny Vardon-Bounes  2 , Jean-Marie Conil  2 , Antoine Rouget  2 , Stéphanie Ruiz  2 , Marion Grare  3 , Olivier Fourcade  2 , Bertrand Suc  4 , Marc Leone  5 , Vincent Minville  2 , Bernard Georges  2
Affiliations
Comparative Study

Outcome of community- versus hospital-acquired intra-abdominal infections in intensive care unit: a retrospective study

Timothée Abaziou et al. BMC Anesthesiol. .

Abstract

Background: To compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications.

Methods: Retrospective study including all patients admitted to 2 ICUs within 48 h of undergoing surgery for peritonitis.

Results: Two hundred twenty-six patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7 and 37.5% in the CA-IAI group and HA-IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15-25] vs. 21 [15-24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7-36] vs. 6[3-12] days, p < 0.001 and 41 [24-66] vs. 17 [7-32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CA-IAI.

Conclusion: CA-IAI group had higher 28-day mortality rate than HA-IAI group. Mortality was similar at 90 days but those with HA-IAI had a prolonged ICU and hospital stay. In addition, they developed more complications.

Keywords: Intensive care unit; Intra-abdominal infection; Microbiology; Outcome; Peritonitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of enrolment. CA-IAI: community-acquired Intraabdominal Infection; HA-IAI: hospital-acquired Intraabdominal Infection
Fig. 2
Fig. 2
Kaplan-Meier curve of survival rate at 28 days, with 95% confidence interval. Blue line: CA-IAI: community-acquired Intraabdominal Infection; Red line: HA-IAI: hospital-acquired Intraabdominal Infection
Fig. 3
Fig. 3
Cox proportional hazard model. CA-IAI: community-acquired Intraabdominal Infection; BMI: Body mass index superior to 23; platelet < 50,000: platelet count inferior to 50,000/mm3; Creatinine > 150: serum creatinine rate superior to 150 μmol/l
See this image and copyright information in PMC

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