1. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study
- Author
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Stefano Rausei, Vincenzo Pappalardo, Marco Ceresoli, Fausto Catena, Massimo Sartelli, Massimo Chiarugi, Yoram Kluger, Andrew Kirkpatrick, Luca Ansaloni, Federico Coccolini, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federico Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Rao Ivatury, Jimmy Xiao, Andrea Lippi, Mario Improta, Francesca Gubbiotti, Andrey Zharikov, Vincent Dubuisson, Michael Sugrue, Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, and Sugrue, M
- Subjects
Male ,medicine.medical_specialty ,Sepsi ,Peritonitis ,NO ,Sepsis ,03 medical and health sciences ,Elderly ,Intra-abdominal infection ,Open abdomen management ,Source control ,0302 clinical medicine ,Postoperative Complications ,Abdomen ,Medicine ,Humans ,Prospective Studies ,Registries ,Open abdomen ,Aged ,Aged, 80 and over ,Univariate analysis ,business.industry ,Potential risk ,Age Factors ,Mean age ,General Medicine ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Observational study ,Female ,business ,Cohort study - Abstract
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 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 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 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.
- Published
- 2020