首页|Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)pres-ence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal infection.This study aimed to describe the epidemiology of ICU patients with pan-creatic infection and assess the relationship between the components of the AbSeS-classification and mortality.Methods:This was a secondary analysis of an international observational study("AbSeS")investigating ICU patients with intra-abdominal infection.Only patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU.Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95％confidence interval(CI).Results:The overall mortality was 35.2％(n=58).The independent risk factors for mortality included older age(OR=1.03,95％CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95％CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95％CI:3.8 to 23.9,P＜0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95％CI:1.3 to 12.2,P=0.013).Gram-negative bacteria were most frequently isolated(n=58,49.2％)without clinically relevant differences in microbial etiology between survivors and non-survivors.Conclusions:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome.In this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse peritonitis,and severity of disease expres-sion,were not associated with an increased mortality risk.

Pancreatic infectionIntensive care unitMortalityIntra-abdominal infectionSepsis

Marie Dejonckheere、Massimo Antonelli、Kostoula Arvaniti、Koen Blot、Ben CreaghBrown、Dylan W.de Lange、Jan De Waele、Mieke Deschepper、Yalim Dikmen、George Dimopoulos、Christian Eckmann、Guy Francois、Massimo Girardis、Despoina Koulenti、Sonia Labeau、Jeffrey Lipman、Fernando Lipovestky、Emilio Maseda、Philippe Montravers、Adam Mikstacki、JoseArtur Paiva、Cecilia Pereyra、Jordi Rello、JeanFrancois Timsit、Dirk Vogelaers、Stijn Blot、the Abdominal Sepsis Study(AbSeS)group on behalf of the Trials Group of the European Society of Inte

展开 >

Department of Internal Medicine and Pediatrics,Faculty of Medicine and Health Sciences,Ghent University,Ghent,Belgium

Department of Anesthesiology,Intensive Care and Emergency Medicine,Fondazione Policlinico Universitario A.Gemelli IRCCS,Rome,Italy

Universitá Cattolica del Sacro Cuore,Rome,Italy

Intensive Care Unit,Papageorgiou University Affiliated Hospital,Thessaloniki,Greece

Department of Epidemiology and Public Health,Sciensano,Ixelles,Belgium

Surrey Perioperative Anaesthetic Critical Care Collaborative Research Group(SPACeR),Royal Surrey County Hospital,Guildford,UK

Department of Clinical and Experimental Medicine,University of Surrey,Guildford,UK

Department of Intensive Care Medicine,University Medical Center Utrecht,University Utrecht,Utrecht,the Netherlands

Department of Intensive Care Medicine,Ghent University Hospital,Ghent Belgium

Data Science Institute,Ghent University Hospital,Ghent Belgium

Department of Anesthesiology and Reanimation,Cerrahpasa School of Medicine,Istanbul University-Cerrahpasa,Istanbul,Turkey

3rd Department of Critical Care,"EVGENIDIO"Hospital,National and Kapodistrian University of Athens,Athens,Greece

Department of General,Visceral and Thoracic Surgery,Klinikum Hannoversch-Muenden,Goettingen University,Göttingen,Germany

Division of Scientific Affairs-Research,European Society of Intensive Care Medicine,Brussels,Belgium

Anesthesia and Intensive Care Department,University Hospital of Modena,Modena,Italy

UQ Centre for Clinical Research,Faculty of Medicine,The University of Queensland,Brisbane,QLD,Australia

2nd Critical Care Department,Attikon University Hospital,Athens,Greece

Department of Nursing,Faculty of Education,Health and Social Work,University College Ghent,Ghent Belgium

Jamieson Trauma Institute,The University of Queensland,Brisbane,QLD,Australia

Nimes University Hospital,University of Montpellier,Nimes,France

Critical Care Department,Hospital of the Interamerican Open University(UAI),Buenos Aires,Argentina

Surgical Critical Care,Department of Anesthesia,Hospital Universitario La Paz-IdiPaz,Madrid,Spain

Université de Paris,INSERM,UMR-S 1152-PHERE,Paris,France

Anesthesiology and Critical Care Medicine,Bichat-Claude Bernard University Hospital,HUPNSV,AP-HP,Paris,France

Faculty of Health Sciences,Poznan University of Medical Sciences,Poznan,Poland

Department of Anaesthesiology and Intensive Therapy,Regional Hospital in Poznan,Poznan,Poland

Intensive Care Department,Centro Hospitalar Universitario S.Joao,Faculty of Medicine,University of Porto,Grupo Infecao e Sepsis,Porto,Portugal

Intensive Care Unit from Hospital Interzonal General de Agudos"Prof Dr Luis Guemes",Buenos Aires,Argentina

Ciberes and Vall d'Hebron Institute of Research,Barcelona,Spain

Université Paris-Cité,LAME,INSERM 1137,Paris,France

AP-HP,Hôpital Bichat,Medical and Infection Diseases ICU(MI2),Paris,France

Department of General Internal Medicine and Infectious Diseases,AZ Delta,Roeselare,Belgium

展开 >

ClinicalTrials.gova Pfizer investigatorinitiated research grant

number NCT03270345

2024

10.1016/j.jointm.2023.06.004

重症医学(英文)

重症医学(英文)

ISSN：
年,卷(期)：2024.4(1)
  • 65