Open Access Review

Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)

Massimo Sartelli1*, Fausto Catena2, Luca Ansaloni3, Ernest Moore4, Mark Malangoni5, George Velmahos6, Raul Coimbra7, Kaoru Koike8, Ari Leppaniemi9, Walter Biffl4, Zsolt Balogh10, Cino Bendinelli10, Sanjay Gupta11, Yoram Kluger12, Ferdinando Agresta13, Salomone Di Saverio14, Gregorio Tugnoli14, Elio Jovine15, Carlos Ordonez16, Carlos Augusto Gomes17, Gerson Alves Pereira18, Kuo-Ching Yuan19, Miklosh Bala20, Miroslav P Peev6, Yunfeng Cui21, Sanjay Marwah22, Sanoop Zachariah23, Boris Sakakushev2425, Victor Kong26, Adamu Ahmed27, Ashraf Abbas28, Ricardo Alessandro Teixeira Gonsaga29, Gianluca Guercioni30, Nereo Vettoretto31, Elia Poiasina3, Offir Ben-Ishay12, Rafael Díaz-Nieto32, Damien Massalou33, Matej Skrovina34, Ihor Gerych35, Goran Augustin36, Jakub Kenig37, Vladimir Khokha38, Cristian Tranà39, Kenneth Yuh Yen Kok40, Alain Chichom Mefire41, Jae Gil Lee42, Suk-Kyung Hong43, Helmut Alfredo Segovia Lohse44, Wagih Ghnnam45, Alfredo Verni46, Varut Lohsiriwat47, Boonying Siribumrungwong48, Alberto Tavares49, Gianluca Baiocchi50, Koray Das51, Julien Jarry52, Maurice Zida53, Norio Sato8, Kiyoshi Murata54, Tomohisa Shoko55, Takayuki Irahara56, Ahmed O Hamedelneel57, Noel Naidoo58, Abdul Rashid Kayode Adesunkanmi59, Yoshiro Kobe60, AK Attri11, Rajeev Sharma11, Federico Coccolini3, Tamer El Zalabany61, Khalid Al Khalifa61, Juan Sanjuan16, Rita Barnabé15 and Wataru Ishii62

Author Affiliations

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 Surgery, Denver Health Medical Center, Denver, CO, USA

5 American Board of Surgery, Philadelphia, PA, USA

6 Harvard Medical School, Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital, Boston, MA, USA

7 Department of Surgery, UC San Diego Health System, San Diego, CA, USA

8 Department of Primary Care & Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan

9 Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland

10 Department of Surgery, University of Newcastle, Newcastle, NSW, Australia

11 Department of Surgery, Govt Medical College and Hospital, Chandigarh, India

12 Department of General Surgery, Rambam Health Care Campus, Haifa, Israel

13 Department of Surgery, Adria Hospital, Adria, Italy

14 Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

15 Department of Surgery, Maggiore Hospital, Bologna, Italy

16 Department of Surgery, Universidad del Valle, Fundacion Valle del Lili, Cali, Colombia

17 Department of Surgery, Monte Sinai Hospital, Juiz de Fora, Brazil

18 Emergency Unit, Department of Surgery, Ribeirão Preto, Brazil

19 Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

20 Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel

21 Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China

22 Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, India

23 Department of Surgery, MOSC medical college, Cochin, India

24 First Clinic of General Surgery, University Hospital /UMBAL/ St George Plovdiv, Plovdiv, Bulgaria

25 General Surgery Clinic, Medical University/University Hospital St.George, Plovdiv, Bulgaria

26 Department of Surgery, Edendale Hospital, Pietermaritzburg, Republic of South Africa

27 Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria

28 Department of Surgery, Mansoura University Hospital, Mansoura, Egypt

29 Department of Surgery, Faculdades Integradas Padre Albino, Catanduva, Brazil

30 Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy

31 Department of Surgery, Mellini Hospital, Chiari (BS), Italy

32 Department of General and Digestive Surgery, Virgen de la Victoria, University Hospital, Malaga, Spain

33 Department of General Surgery and Surgical Oncology, Université de Nice Sophia-Antipolis, Universitary Hospital of Nice, Nice, France

34 Department of Surgery, Hospital and Oncological Centre, Novy Jicin, Czech Republic

35 Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine

36 Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia

37 3rd Department of General Surger Jagiellonian Univeristy, Narutowicz Hospital, Krakow, Poland

38 Department of Surgery, Mozyr City Hospital, Mozyr, Belarus

39 Department of Surgery, Ancona University, Ancona, Italy

40 Department of Surgery, Ripas Hospital, Bandar Seri Begawan, Brunei

41 Clinical Sciences, Regional Hospitals Limbe and Buea, Limbe, Cameroon

42 Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

43 Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan, Seoul, Republic of Korea

44 II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Asuncion, Paraguay

45 Department of Surgery, Khamis Mushayt General Hospital, Khamis Mushayt, Saudi Arabia

46 Department of Surgery, Cutral Co Clinic, Neuquen, Argentina

47 Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand

48 Department of Surgery, Thammasat University Hospital, Pathumthani, Thailand

49 Department of Surgery, Hospital Regional de Alta Especialidad del Bajio, Leon, Mexico

50 Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy

51 General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey

52 Visceral Surgery, Military Hospital Desgenettes, Lyon, France

53 Visceral Surgery, Teaching Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso

54 Department of Acute and Critical care medicine, Tokyo Medical and Dental University, Tokyo, Japan

55 The Shock Trauma and Emergency Medical Center, Matsudo City Hospital, Chiba, Japan

56 Emergency and Critical Care Center of Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan

57 Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland

58 Department of Surgery, Port Shepstone Hospital, Port Shepstone, South Africa

59 Department of Surgery, College of Health Sciences, Obafemi Awolowo University Hospital, Ile-Ife, Nigeria

60 Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan

61 Department of Surgery, Bahrain Defence Force Hospital, Manama, Bahrain

62 Department of Emergency Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan

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World Journal of Emergency Surgery 2013, 8:1  doi:10.1186/1749-7922-8-1

Published: 3 January 2013

Abstract

Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18–98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients.

The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.