Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study.
Elderly
Intra-abdominal infection
Open abdomen management
Sepsis
Source control
Journal
International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
15
05
2020
revised:
09
07
2020
accepted:
11
08
2020
pubmed:
7
9
2020
medline:
12
2
2021
entrez:
6
9
2020
Statut:
ppublish
Résumé
Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
Sections du résumé
BACKGROUND
BACKGROUND
Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection.
METHODS
METHODS
Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up.
RESULTS
RESULTS
A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality.
CONCLUSIONS
CONCLUSIONS
This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
Identifiants
pubmed: 32891828
pii: S1743-9191(20)30633-6
doi: 10.1016/j.ijsu.2020.08.030
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
240-244Investigateurs
Giulia Montori
(G)
Fracensco Salvetti
(F)
Paola Fugazzola
(P)
Ionut Negoi
(I)
Monica Zese
(M)
Savino Occhionorelli
(S)
Sergei Shlyapnikov
(S)
Andrew Kirkpatrick
(A)
Zaza Demetrashvili
(Z)
Daniele Dondossola
(D)
Orestis Ioannidis
(O)
Giuseppe Novelli
(G)
Mirco Nacoti
(M)
Desmond Khor
(D)
Kenji Inaba
(K)
Demetrios Demetriades
(D)
Torsten Kaussen
(T)
Asri Che Jusoh
(AC)
Wagih Ghannam
(W)
Boris Sakakushev
(B)
Ohad Guetta
(O)
Agron Dogjani
(A)
Stefano Costa
(S)
Sandeep Singh
(S)
Dimitrios Damaskos
(D)
Arda Isik
(A)
Kuo-Ching Yuan
(KC)
Francesco Trotta
(F)
Stefano Rausei
(S)
Aleix Martinez-Perez
(A)
Giovanni Bellanova
(G)
Vinicius Cordeiro Fonseca
(VC)
Fernando Hernández
(F)
Athanasios Marinis
(A)
Wellington Fernandes
(W)
Martha Quiodettis
(M)
Miklosh Bala
(M)
Andras Vereczkei
(A)
Rafael Curado
(R)
Gustavo Pereira Fraga
(GP)
Bruno M Pereira
(BM)
Mahir Gachabayov
(M)
Guillermo Perez Chagerben
(GP)
Miguel Leon Arellano
(ML)
Sefa Ozyazici
(S)
Gianluca Costa
(G)
Tugan Tezcaner
(T)
Matteo Porta
(M)
Yousheng Li
(Y)
Faruk Karateke
(F)
Dimitrios Manatakis
(D)
Federico Mariani
(F)
Federico Lora
(F)
Ivan Sahderov
(I)
Boyko Atanasov
(B)
Sergio Zegarra
(S)
Luca Fattori
(L)
Rao Ivatury
(R)
Jimmy Xiao
(J)
Yoram Kluger
(Y)
Andrea Lippi
(A)
Mario Improta
(M)
Francesca Gubbiotti
(F)
Andrey Zharikov
(A)
Vincent Dubuisson
(V)
Michael Sugrue
(M)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.