From: Microbiological profile of patients treated for postoperative peritonitis: temporal trends 1999–2019
Variables | Overall N = 422 patients | Missing value | MDRO group N = 188 patients | MDRO-free group N = 234 patients | p value |
---|---|---|---|---|---|
Demographic characteristics | |||||
Age—years, median [IQR] | 61 [49–73] | 0 | 64 [53–74] | 59 [46–72] | 0.0137 |
Patients aged ≥ 80 years—n (%) | 45 (11) | 0 | 24 (13) | 21 (9) | 0.208 |
Male sex—n (%) | 221 (52) | 0 | 115 (61) | 106 (45) | 0.0012 |
Medical history and underlying diseases | |||||
No underlying disease—n (%) | 9 (2) | 0 | 4 (2) | 5 (2) | 1.000 |
Rapidly fatal underlying disease (survival < 1 year)—n (%) | 111 (26) | 0 | 58 (31) | 53 (23) | 0.057 |
Charlson score, median [IQR] | 4 [1–6] | 0 | 4 [2–6] | 3 [1–5] | 0.027 |
Diabetes mellitus*—n (%) | 77 (18) | 0 | 38 (20) | 39 (17) | 0.348 |
Malignancy*—n (%) | 165 (39) | 0 | 82 (44) | 83 (35) | 0.088 |
Chronic obstructive pulmonary disease*—n (%) | 46 (11) | 0 | 25 (13) | 21 (9) | 0.156 |
Moderate to severe chronic kidney disease*—n (%) | 17 (4) | 0 | 7 (4) | 10 (4) | 0.809 |
Immunosuppression—n (%) | 75 (18) | 0 | 40 (21) | 35 (15) | 0.091 |
Initial surgery | |||||
Emergency surgery—n (%) | 162 (38) | 0 | 82 (44) | 80 (34) | 0.047 |
Contaminated or septic surgery—n (%) | 159 (38) | 0 | 79 (42) | 80 (34) | 0.098 |
Digestive surgery—n (%) | 367 (87) | 0 | 166 (88) | 201 (86) | 0.466 |
Bariatric surgery—n (%) | 79 (19) | 0 | 19 (24) | 60 (76) | < 0.0001 |
Gynaecological surgery—n (%) | 24 (6) | 0 | 6 (3) | 18 (8) | 0.056 |
Curative antibiotic therapy—n (%) | 116 (27) | 0 | 55 (29) | 61 (26) | 0.054 |
Abdominal reoperation before diagnosis of POP—n (%) | 114 (27) | 0 | 53 (28) | 61 (26) | 0.625 |
Delay between initial surgery and reoperation for POP, days, median [IQR] | 7 [4–12] | 1 | 8 [4–13] | 7 [4–11.5] | 0.214 |
Antimicrobial therapy before reoperation for POP—n (%) | 278 (66) | 1 | 130 (69) | 148 (63) | 0.203 |
Ongoing antimicrobial therapy at the time of diagnosis of POP—n (%) | 232 (56) | 4 | 111 (60) | 121 (52) | 0.099 |
Surgical management of POP | |||||
Colonic or rectal source of contamination—n (%) | 119 (28) | 0 | 71 (64) | 48 (42) | 0.0008 |
Small bowel source of contamination—n (%) | 117 (28) | 0 | 55 (56) | 62 (53) | 0.599 |
Gastroduodenal source of contamination—n (%) | 99 (23) | 0 | 28 (38) | 71 (60) | 0.004 |
Pancreas and biliary source of contamination—n (%) | 23 (5) | 0 | 13 (7) | 10 (4) | 0.281 |
Perforation—n (%) | 124 (29) | 0 | 57 (30) | 67 (29) | 0.705 |
Anastomosis dehiscence—n (%) | 155 (37) | 0 | 64 (34) | 91 (39) | 0.304 |
Abscess—n (%) | 80 (19) | 0 | 37 (20) | 43 (18) | 0.733 |
No cause—n (%) | 67 (16) | 0 | 26 (14) | 41 (18) | 0.302 |
Source control for POP | |||||
Resection/excision—n (%) | 292 (69) | 4 | 128 (68) | 164 (70) | 0.717 |
Ostomy—n (%) | 242 (57) | 4 | 115 (61) | 127 (54) | 0.136 |
Anastomosis—n (%) | 37 (9) | 4 | 12 (4) | 25 (11) | 0.165 |
Patch/suture—n (%) | 109 (26) | 4 | 40 (21) | 69 (29) | 0.055 |
Intraoperative drainage—n (%) | 351 (82) | 4 | 156 (83) | 195 (83) | 1.000 |
Severity criteria at the time of ICU admission for POP | |||||
SAPS II score, median [IQR] | 47 [35–58] | 1 | 50 [36–59] | 45 [33–57.5] | 0.059 |
SAPS II score ≥ 40—n (%) | 281 (67) | 1 | 110 (71) | 171 (64) | 0.160 |
SOFA score, median [IQR] | 8 [5–10] | 5 | 8 [5–10] | 8 [4–10] | 0.992 |
Respiratory failure—n (%) | 184 (45) | 16 | 79 (43) | 105 (47) | 0.485 |
Hemodynamic failure—n (%) | 284 (70) | 16 | 131 (72) | 153 (68) | 0.421 |
Renal failure—n (%) | 109 (27) | 17 | 42 (23) | 67 (30) | 0.115 |
Outcome | |||||
Reoperation—n (%) | 203 (48) | 0 | 89 (47) | 114 (49) | 0.778 |
Duration of ICU stay of survivors—days; median [IQR] | 14 [8–25] | 0 | 16 [9–28] | 12 [7–25] | 0.080 |
Duration of mechanical ventilation—days; median [IQR] | 7 [3–15] | 0 | 7 [4–16] | 6 [3–15] | 0.214 |
Death in ICU—n (%) | 134 (32) | 0 | 64 (34) | 70 (30) | 0.365 |
Delay of death in the ICU—days; median [IQR] | 14 [3–26] | 0 | 12 [3–27] | 15 [3–25] | 0.675 |
Death in hospital—n (%) | 148 (35) | 0 | 76 (40) | 72 (31) | 0.038 |