Skip to main content
Top
Published in: Intensive Care Medicine 2/2014

01-02-2014 | Editorial

Prognostic factors for mortality in (fecal) peritonitis: back to the roots!

Authors: Christian Eckmann, Matteo Bassetti

Published in: Intensive Care Medicine | Issue 2/2014

Login to get access

Excerpt

We have just a few reliable data about prognosis in abdominal sepsis in general and fecal peritonitis in particular. This alone is a good reason why the study by Tridente et al. [1] published in this issue of Intensive Care Medicine is an important contribution to this topic. The authors present a large cohort of patients treated in different European health-care settings and the study provides some of the best available evidence we have for these critically ill patients. Tridente et al. conclude that in a large cohort of patients admitted to European ICUs with fecal peritonitis the 6-month mortality was 31.6 %. The most consistent predictors of mortality across all time points were increased age, development of acute renal dysfunction during the first week of admission, and hypothermia on day 1 of ICU admission. …
Literature
1.
go back to reference Tridente A, Clarke GM, Walden A, McKechnie S, Hutton P, Mills GH, Gordon AC, Holloway PAH, Chiche JD, Bion J, Stuber F, Garrard C, Hinds C and the GenOSept Investigators (2013) Patients with faecal peritonitis admitted to European intensive care units: an epidemiological survey of the GenOSept cohort. Intensive Care Med. doi: 10.1007/-013-3158-7 Tridente A, Clarke GM, Walden A, McKechnie S, Hutton P, Mills GH, Gordon AC, Holloway PAH, Chiche JD, Bion J, Stuber F, Garrard C, Hinds C and the GenOSept Investigators (2013) Patients with faecal peritonitis admitted to European intensive care units: an epidemiological survey of the GenOSept cohort. Intensive Care Med. doi: 10.​1007/​-013-3158-7
2.
go back to reference Kumar A, Ellis P, Arabi Y et al (2009) Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 136:1237–1248PubMed Kumar A, Ellis P, Arabi Y et al (2009) Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 136:1237–1248PubMed
3.
go back to reference Engel C, Brunkhorst FM, Bone HG et al (2007) Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 33:606–618PubMedCrossRef Engel C, Brunkhorst FM, Bone HG et al (2007) Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 33:606–618PubMedCrossRef
4.
go back to reference Eckmann C, Dryden M, Montravers P, Kozlov R, Sganga G (2011) Antimicrobial treatment of “complicated” intra-abdominal infections and the new IDSA guidelines—a commentary and an alternative European approach. Eur J Med Res 16:115–126PubMedCentralPubMedCrossRef Eckmann C, Dryden M, Montravers P, Kozlov R, Sganga G (2011) Antimicrobial treatment of “complicated” intra-abdominal infections and the new IDSA guidelines—a commentary and an alternative European approach. Eur J Med Res 16:115–126PubMedCentralPubMedCrossRef
6.
go back to reference Inui T, Haridas M, Claridge JA, Malangoni MA (2009) Mortality for intra-abdominal infection is associated with intrinsic risk factors rather than the source of infection. Surgery 146:652–662CrossRef Inui T, Haridas M, Claridge JA, Malangoni MA (2009) Mortality for intra-abdominal infection is associated with intrinsic risk factors rather than the source of infection. Surgery 146:652–662CrossRef
7.
go back to reference Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM et al (2012) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Intensive Care Med 39:165–228CrossRef Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM et al (2012) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Intensive Care Med 39:165–228CrossRef
8.
go back to reference Linder M, Wacha H, Feldmann U, Wesch G, Steifensand RA, Gundlach E (1987) Der Mannheimer Peritonitis-Index—Ein Instrument zur intraoperativen Prognose der Peritonitis. Chirurg 58:84–92PubMed Linder M, Wacha H, Feldmann U, Wesch G, Steifensand RA, Gundlach E (1987) Der Mannheimer Peritonitis-Index—Ein Instrument zur intraoperativen Prognose der Peritonitis. Chirurg 58:84–92PubMed
9.
go back to reference Billing A, Frohlich D, Schildberg FW (1994) Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Peritonitis Study Group. Br J Surg 81:209–213PubMedCrossRef Billing A, Frohlich D, Schildberg FW (1994) Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Peritonitis Study Group. Br J Surg 81:209–213PubMedCrossRef
10.
go back to reference van Ruler O, Kiewiet J, Boer K, Lamme B, Gouma D, Boermeester M, Reitsma J (2011) Failure of available scoring systems to predict ongoing infection in patients with abdominal sepsis after their initial emergency laparotomy. BMC Surgery 11:1–9CrossRef van Ruler O, Kiewiet J, Boer K, Lamme B, Gouma D, Boermeester M, Reitsma J (2011) Failure of available scoring systems to predict ongoing infection in patients with abdominal sepsis after their initial emergency laparotomy. BMC Surgery 11:1–9CrossRef
11.
go back to reference Singh R, Kumar N, Bhattacharya A, Vajifdar H (2011) Preoperative predictors of mortality in adult patients with perforation. Indian J Crit Care Med 15:157–163PubMedCentralPubMedCrossRef Singh R, Kumar N, Bhattacharya A, Vajifdar H (2011) Preoperative predictors of mortality in adult patients with perforation. Indian J Crit Care Med 15:157–163PubMedCentralPubMedCrossRef
12.
go back to reference McLauchlan GJ, Anderson ID, Grant IS, Fearson KCH (1995) Outcome of patients with abdominal sepsis treated in an intensive care unit. Br J Surg 82:524–529PubMedCrossRef McLauchlan GJ, Anderson ID, Grant IS, Fearson KCH (1995) Outcome of patients with abdominal sepsis treated in an intensive care unit. Br J Surg 82:524–529PubMedCrossRef
13.
go back to reference Mulier S, Penninckx P, Verwaest C, Filez L et al (2003) Factors affecting mortality in generalized postoperative peritonitis: multivariate analysis in 96 patients. World J Surg 27:379–384PubMedCrossRef Mulier S, Penninckx P, Verwaest C, Filez L et al (2003) Factors affecting mortality in generalized postoperative peritonitis: multivariate analysis in 96 patients. World J Surg 27:379–384PubMedCrossRef
14.
go back to reference Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596PubMedCrossRef Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596PubMedCrossRef
15.
go back to reference Wong PF, Gilliam AD, Kumar S et al (2005) Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults. Cochrane Database Syst Rev 18:CD004539 Wong PF, Gilliam AD, Kumar S et al (2005) Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults. Cochrane Database Syst Rev 18:CD004539
Metadata
Title
Prognostic factors for mortality in (fecal) peritonitis: back to the roots!
Authors
Christian Eckmann
Matteo Bassetti
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-013-3155-x

Other articles of this Issue 2/2014

Intensive Care Medicine 2/2014 Go to the issue