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

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

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.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Community-Acquired Infections / mortality
  • Community-Acquired Infections / surgery*
  • Critical Care / methods
  • Cross Infection / mortality
  • Cross Infection / surgery*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units*
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Peritonitis / mortality
  • Peritonitis / surgery*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Severity of Illness Index