Research article
Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study
1 Department of Surgery, Macerata Hospital, Macerata, Italy
2 Emergency Surgery, Maggiore Parma Hospital, Parma, Italy
3 Department of General Surgery, Ospedali Riuniti, Bergamo, Italy
4 Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland
5 Department of Surgery, Sisli Florence Nigtingale Hospital, Istanbul, Turkey
6 Department of Surgery, Radboud University Nijmegen Medical Centre Nijmegen, Nijmegen, Netherlands
7 Clinic of Infectious Diseases, Department of Internal Medicine Geriatrics and Nephrologic Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy
8 Department of Neuroscience, UT Southwestern Medical Center, Dallas, USA
9 General, Oncological, Geriatrical Surgery and advanced Technology, University Federico II, Naples, Italy
10 Department of Human Pathology and Oncology, Policlinico le Scotte, University Hospital, Siena, Italy
11 Department of Surgery, Fatebenefratelli Isola Tiberina hospital, Rome, Italy
12 Department of General Surgery, Bakirkoy Training Research Hospital, Istanbul, Turkey
13 Department of General Surgery, Baskent University Faculty of Medicine, Adana, Turkey
14 Department of Surgery, Parc Tauli University Hospital, Bercelona, Spain
15 Emergency Department, Umberto I, Hospital, Rome, Italy
16 Department of Gastroenterological surgery Turku, University Central Hospital, Turku, Finland
17 Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia
18 Department of General Surgery, First Clinic of General Surgery University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria
19 Departement of Emergency Surgery, Pôle Urgences, CHU de Nice, Université de Nice Sophia-antipolis, Nice, France
20 Department of Surgery, AZ Maria Middelares, Ghent, Belgium
21 3rd Department of Generał Surgery, Narutowicz Hospital, Krakow, Połand
22 Department of Surgery, Maggiore Hospital, Bologna, Italy
23 Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy
24 Department of Surgery, University of Insubria (Chief Renzo Dionigi), Varese, Italy
25 Department GI-surgery, Kuopio University hospital, Kuopio, Finland
26 2nd Department of Surgery, Jagiellonian University Krakow, Krakow, Poland
27 Department of Surgery Hospital, Oncological Centre Novy Jicin, Novy Jicin, Czech Republic
28 Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
29 Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV Lausanne, Lausanne, Switzerland
30 Department of General Surgery, Lviv, Emergency hospital, Lviv, Ukraine
31 Center of general surgery, North Estonia Regional Hospital, Tallinn, Estonia
32 Intensive Care Klinikum, Magdeburg gGmbH, Magdeburg, Germany
33 Department of Emergency Surgery, Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy
34 Department of Hepato-biliary and Pancreatic surgery and Transplantology, Military Medical Hospital, Sofia, Bulgaria
35 Department of Surgery, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy
36 General and Vascular Surgery, M.Mellini Hospital, Chiari, Italy
37 Department of surgery, University Clinic Center Tuzla, Tuzla, Bosnia and Herzegovina
38 Department of General and Colorectal Surgery, University Hospital, Central Veterans Hospital, Lodz, Poland
39 Surgical Department, Santa Croce e Carle hospital, Cuneo, Italy
40 Department of Surgery, São Teotónio Hospital, Viseu, Portugal
41 Department of HPB and Liver Transplant Surgery, Royal Free Hospital, London, United Kingdom
42 IInd Surgical department of Medical faculty Comenius University, University Hospital Bratislava, st. Cyril and Methodius Hospital Bratislava, Bratislava, Slovakia
43 Department of Surgery, Medical School University of Pécs, Pécs, Hungary
44 Department of Abdominal Surgery, University Clinical Centre of Kosovo, Prishtina, Kosovo
45 2nd Department of Surgery, General Army Hospital of AthensBratislava, Athens, Greece
46 Department of General and Digestive Surgery, Virgen de la Victoria University Hospital, Malaga, Spain
47 Cristian Mesina, Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
48 Surgical Department, General hospital Jesenice, Jesenice, Slovenia
49 Department of Surgery, Andosilla Hospital, Civita Castellana, Italy
50 General Surgery, Ospedale Civile, Adria, Italy
51 Pietro Coletta Department of Surgery, Jesi Hospital, Jesi, Italy
52 Department of Gastrointestinal Surgery, North Carelian Central Hospital, Joensuu, Finland
53 Oncologic, Digestive and Emergency Surgery, Bocage Hospital, Dijon, France
54 Department of General Surgery, General Hospital of Larissa, Larissa, Greece
55 Department of General Surgery, University Hospital of Heraklion, Heraklion, Greece
56 Surgical Department, Mozyr, Belarus
57 Department of Pediatric Surgery, Paediatric Surgery and Orthopaedic Clinic, Niš, Serbia
58 General Surgery, Clinical Hospital at Chelyabinsk Station OJSC, Russian Railroads, Chelyabinsk City, Russian Federation
59 First Department of Surgery, Tzanion General Hospital, Piraeus, Greece
60 Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
61 Deparment of Surgery - Downtown Campus, University Hospital of Munich, Munich, Germany
62 General and Emergency surgery, SG Bosco Hospital, Torino, Italy
63 Department of General Surgery, Hospital La Paz Madrid, Madrid, Spain
64 Department of Gynecology and Obstetrics, CHI Poissy Saint Germain en Laye, Poissy, University Versailles Saint-Quentin en Yvelines, Versailles, France
65 Chirurgie Viscerale, Digestive et Oncologique Hospital Prive, Arras les Bonnettes, Arras, France
66 Department of General Surgery, Hospital São João Porto, Porto, Portugal
67 Division of Transplantation, Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
68 1st Surgical Department, General Regional Hospital, George Papanikolaou, Thessaloniki, Greece
69 Department of Abdominal Surgery, UMC Ljubljana, Ljubljana, Slovenia
World Journal of Emergency Surgery 2012, 7:15 doi:10.1186/1749-7922-7-15
Published: 21 May 2012Abstract
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°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.
