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1. Complicated intrabdominal infections in europe: preliminary data from the first three months of the CIAO study

Author

Sartelli M, Catena F, Ansaloni L, Leppaniemi A, Taviloglu K, van Goor H, Viale P, Lazzareschi DV, Marrelli D, Colizza S, Scibé R, Alis H, Torer N, Navarro S, Catani M, Kauhanen S, Augustin G, Sakakushev B, Massalou D, Pletinckx P, Kenig J, Di Saverio S, Guercioni G, Rausei S, Laine S, Major P, Skrovina M, Angst E, Pittet O, Gerych I, Tepp J, Weiss G, Vasquez G, Vladov N, Tranà C, Vettoretto N, Delibegovic S, Dziki A, Giraudo G, Pereira J, Poiasina E, Tzerbinis H, Hutan M, Vereczkei A, Krasniqi A, Seretis C, Diaz Nieto R, Mesina C, Rems M, Campanile FC, Agresta F, Coletta P, Uotila Nieminen M, Dente M, Bouliaris K, Lasithiotakis K, Khokha V, Zivanović D, Smirnov D, Marinis A, Negoi I, Ney L, Bini R, Leon M, Aloia S, Huchon C, Moldovanu R, de Melo RB, Giakoustidis D, Ioannidis O, Cucchi M, Pintar T, Jovine E., DE WERRA, CARLO, Sartelli, M, Catena, F, Ansaloni, L, Leppaniemi, A, Taviloglu, K, van Goor, H, Viale, P, Lazzareschi, Dv, DE WERRA, Carlo, Marrelli, D, Colizza, S, Scibé, R, Alis, H, Torer, N, Navarro, S, Catani, M, Kauhanen, S, Augustin, G, Sakakushev, B, Massalou, D, Pletinckx, P, Kenig, J, Di Saverio, S, Guercioni, G, Rausei, S, Laine, S, Major, P, Skrovina, M, Angst, E, Pittet, O, Gerych, I, Tepp, J, Weiss, G, Vasquez, G, Vladov, N, Tranà, C, Vettoretto, N, Delibegovic, S, Dziki, A, Giraudo, G, Pereira, J, Poiasina, E, Tzerbinis, H, Hutan, M, Vereczkei, A, Krasniqi, A, Seretis, C, Diaz Nieto, R, Mesina, C, Rems, M, Campanile, Fc, Agresta, F, Coletta, P, Uotila Nieminen, M, Dente, M, Bouliaris, K, Lasithiotakis, K, Khokha, V, Zivanović, D, Smirnov, D, Marinis, A, Negoi, I, Ney, L, Bini, R, Leon, M, Aloia, S, Huchon, C, Moldovanu, R, de Melo, Rb, Giakoustidis, D, Ioannidis, O, Cucchi, M, Pintar, T, and Jovine, E.

Published
2012

2. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

Author

Sartelli, M., Catena, F., Ansaloni, L., Leppaniemi, A., Taviloglu, K., Goor, H. van, Viale, P., Lazzareschi, D.V., de Werra, C., Marrelli, D., Colizza, S., Scibe, R., Alis, H., Torer, N., Navarro, S., Catani, M., Kauhanen, S., Augustin, G., Sakakushev, B., Massalou, D., Pletinckx, P., Kenig, J., Di Saverio, S., Guercioni, G., Rausei, S., Laine, S., Major, P., Skrovina, M., Angst, E., Pittet, O., Gerych, I., Tepp, J., Weiss, G., Vasquez, G., Vladov, N., Trana, C., Vettoretto, N., Delibegovic, S., Dziki, A., Giraudo, G., Pereira, J., Poiasina, E., Tzerbinis, H., Hutan, M., Vereczkei, A., Krasniqi, A., Seretis, C., Diaz-Nieto, R., Mesina, C., Rems, M., Campanile, F.C., Agresta, F., Coletta, P., Uotila-Nieminen, M., Dente, M., Bouliaris, K., Lasithiotakis, K., Khokha, V., Zivanovic, D., Smirnov, D., Marinis, A., Negoi, I., Ney, L., Bini, R., Leon, M., Aloia, S., Huchon, C., Moldovanu, R., de Melo, R.B., Giakoustidis, D., Ioannidis, O., Cucchi, M., Pintar, T., Jovine, E., Sartelli, M., Catena, F., Ansaloni, L., Leppaniemi, A., Taviloglu, K., Goor, H. van, Viale, P., Lazzareschi, D.V., de Werra, C., Marrelli, D., Colizza, S., Scibe, R., Alis, H., Torer, N., Navarro, S., Catani, M., Kauhanen, S., Augustin, G., Sakakushev, B., Massalou, D., Pletinckx, P., Kenig, J., Di Saverio, S., Guercioni, G., Rausei, S., Laine, S., Major, P., Skrovina, M., Angst, E., Pittet, O., Gerych, I., Tepp, J., Weiss, G., Vasquez, G., Vladov, N., Trana, C., Vettoretto, N., Delibegovic, S., Dziki, A., Giraudo, G., Pereira, J., Poiasina, E., Tzerbinis, H., Hutan, M., Vereczkei, A., Krasniqi, A., Seretis, C., Diaz-Nieto, R., Mesina, C., Rems, M., Campanile, F.C., Agresta, F., Coletta, P., Uotila-Nieminen, M., Dente, M., Bouliaris, K., Lasithiotakis, K., Khokha, V., Zivanovic, D., Smirnov, D., Marinis, A., Negoi, I., Ney, L., Bini, R., Leon, M., Aloia, S., Huchon, C., Moldovanu, R., de Melo, R.B., Giakoustidis, D., Ioannidis, O., Cucchi, M., Pintar, T., and Jovine, E.

Abstract

Contains fulltext : 110654.pdf (publisher's version ) (Open Access), The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38 degrees C or less than 36 degrees C by the third post-operative day were statistically significant indicators of patient mortality.

Published
2012

3. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Author

Sartelli Massimo, Catena Fausto, Ansaloni Luca, Leppaniemi Ari, Taviloglu Korhan, van Goor Harry, Viale Pierluigi, Lazzareschi Daniel, Coccolini Federico, Corbella Davide, de Werra Carlo, Marrelli Daniele, Colizza Sergio, Scibè Rodolfo, Alis Halil, Torer Nurkan, Navarro Salvador, Sakakushev Boris, Massalou Damien, Augustin Goran, Catani Marco, Kauhanen Saila, Pletinckx Pieter, Kenig Jakub, Di Saverio Salomone, Jovine Elio, Guercioni Gianluca, Skrovina Matej, Diaz-Nieto Rafael, Ferrero Alessandro, Rausei Stefano, Laine Samipetteri, Major Piotr, Angst Eliane, Pittet Olivier, Herych Ihor, Agresta Ferdinando, Vettoretto Nereo, Poiasina Elia, Tepp Jaan, Weiss Gunter, Vasquez Giorgio, Vladov Nikola, Tranà Cristian, Delibegovic Samir, Dziki Adam, Giraudo Giorgio, Pereira Jorge, Tzerbinis Helen, van Dellen David, Hutan Martin, Vereczkei Andras, Krasniqi Avdyl, Seretis Charalampos, Mesina Cristian, Rems Miran, Campanile Fabio, Coletta Pietro, Uotila-Nieminen Mirjami, Dente Mario, Bouliaris Konstantinos, Lasithiotakis Konstantinos, Khokha Vladimir, Zivanovic Dragoljub, Smirnov Dmitry, Marinis Athanasios, Negoi Ionut, Ney Ludwig, Bini Roberto, Leon Miguel, Aloia Sergio, Huchon Cyrille, Moldovanu Radu, de Melo Renato, Giakoustidis Dimitrios, Ioannidis Orestis, Cucchi Michele, Pintar Tadeja, Krivokapic Zoran, and Petrovic Jelena

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

Published
2012
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4. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

Author

Sartelli Massimo, Catena Fausto, Ansaloni Luca, Leppaniemi Ari, Taviloglu Korhan, van Goor Harry, Viale Pierluigi, Lazzareschi Daniel, de Werra Carlo, Marrelli Daniele, Colizza Sergio, Scibé Rodolfo, Alis Halil, Torer Nurkan, Navarro Salvador, Catani Marco, Kauhanen Saila, Augustin Goran, Sakakushev Boris, Massalou Damien, Pletinckx Pieter, Kenig Jakub, Di Saverio Salomone, Guercioni Gianluca, Rausei Stefano, Laine Samipetteri, Major Piotr, Skrovina Matej, Angst Eliane, Pittet Olivier, Gerych Ihor, Tepp Jaan, Weiss Guenter, Vasquez Giorgio, Vladov Nikola, Tranà Cristian, Vettoretto Nereo, Delibegovic Samir, Dziki Adam, Giraudo Giorgio, Pereira Jorge, Poiasina Elia, Tzerbinis Helen, Hutan Martin, Vereczkei Andras, Krasniqi Avdyl, Seretis Charalampos, Diaz-Nieto Rafael, Mesina Cristian, Rems Miran, Campanile Fabio, Agresta Ferdinando, Coletta Pietro, Uotila-Nieminen Mirjami, Dente Mario, Bouliaris Konstantinos, Lasithiotakis Konstantinos, Khokha Vladimir, Zivanović Dragoljub, Smirnov Dmitry, Marinis Athanasios, Negoi Ionut, Ney Ludwig, Bini Roberto, Leon Miguel, Aloia Sergio, Huchon Cyrille, Moldovanu Radu, de Melo Renato, Giakoustidis Dimitrios, Ioannidis Orestis, Cucchi Michele, Pintar Tadeja, and Jovine Elio

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012). This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 912 patients with a mean age of 54.4 years (range 4–98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified. The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality. White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.

Published
2012
Full Text
View/download PDF

5. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Author

Elif Colak, Iyiade Olaoye, Raghuveer Mn, Tugan Tezcaner, David W da Costa, Varut Lohsiriwat, Vinod V. Prabhu, Tadeja Pintar, Fausto Catena, Raul Coimbra, Daniel Rios-Cruz, Zaza Demetrashvili, Dimitrios Anyfantakis, Isidoro Di Carlo, John Agboola, Konstantinos Pouggouras, Charalampos Spyropoulos, AA Munyika, Sanjay Marwah, Stefano Rausei, Giovanni Bellanova, Francesco Pata, András Vereczkei, Piotr Major, Nereo Vettoretto, Ari Leppäniemi, Ramakrishnapillai Padmakumar, Geanina Loredana Curca, Oussama Baraket, Marco Catani, Massimo Sartelli, Miguel Leon, Konstantinos Bouliaris, Maria Luisa Sánchez de Molina, Eftychios Lostoridis, Gianfranco Cocorullo, Bandar Alharthi, Ionut Negoi, Zygimantas Kuliesius, Sanjay Gupta, Maurice Zida, Terry Curry, Savas Bayrak, Frederic Branger, Pedro Leão, Teresa Giménez Maurel, Saleh Abdel Kader, Cristian Mesina, Marcelo A. Beltrán, Eudaldo López-Tomassetti Fernandez, Carlos A. Ordoñez, Martin Hutan, Jakub Kenig, Avidyl Krasniqi, Sumita A Jain, Tonguç Utku Yılmaz, Miran Rems, Dmitry Smirnov, Gabrielle H. van Ramshorst, Robin Kaushik, Renato Bessa Melo, Mario Paulo Faro, Ouadii Mouaqit, Asri Che Jusoh, Adamu Amhed, Abdelkarim H. Omari, Jaan Tepp, Ali Guner, Miklosh Bala, Charampolos Seretis, Alain Chichom-Mefire, Nadezda Drozdova, Matej Skrovina, Saila Kauhanen, Aurélien Venara, Aintzane Lizarazu Pérez, Kuo-Ching Yuan, Adesina Ajibade, Silvia Figueiredo Costa, Yoshimitsu Izawa, Mahir Gachabayov, Michael McFarlane, Ricardo Alessandro Teixeira Gonsaga, Ashok Kshirsagar, Jae Gil Lee, Gustavo Pereira Fraga, Koray Das, Jan Ulrych, Tamer El Zalabany, Luca Ansaloni, Victor Y. Kong, Matti Tolonen, Jorge Pereira, Nick Michalopoulos, Georgios Gkiokas, Arda Isik, Orestis Ioannidis, Aleix Martínez-Pérez, Seckin Akkucuk, Giovanni Sinibaldi, Gabriela Elisa Nita, Jae Il Kim, Yunfeng Cui, Federico Coccolini, Ewen A. Griffiths, Roberto Bini, Salomone Di Saverio, Mushira Enani, Boris Sakakushev, Mustafa Yener Uzunoglu, Asrhaf Abbas, Fikri M. Abu-Zidan, David van Dellen, Sandra Gutierrez, Samir Delibegovic, Ioannis Nikolopoulos, Daniele Brunelli, Vishal G Shelat, Ferdinando Agresta, Gerson Alves Pereira Júnior, Goran Augustin, Mantas Jokubauskas, Zeynep Özkan, Sanoop K. Zachariah, Nutu Vlad, Romeo Lages Simões, Konstantinos Lasithiotakis, Giorgio Vasquez, Matthew Boal, Daniele Marrelli, Sanjay Kumar Yadav, Paola Rodriguez Ossa, Vladimir Khokha, Carlos Augusto Gomes, Justas Zilinskas, Gianluca Guercioni, Renol M. Koshy, Gian Luca Baiocchi, Athanasios Marinis, Aleksandar Karamarkovic, Radu Moldovanu, Andrey V. Borodach, Myftar Torba, II kirurgian klinikka, Clinicum, [et al.], Universidade do Minho, Sartelli, M., Abu Zidan, F., Catena, F., Griffiths, E., Di Saverio, S., Coimbra, R., Ordoñez, C., Leppaniemi, A., Fraga, G., Coccolini, F., Agresta, F., Abbas, A., Abdel Kader, S., Agboola, J., Amhed, A., Ajibade, A., Akkucuk, S., Alharthi, B., Anyfantakis, D., Augustin, G., Baiocchi, G., Bala, M., Baraket, O., Bayrak, S., Bellanova, G., Beltràn, M., Bini, R., Boal, M., Borodach, A., Bouliaris, K., Branger, F., Brunelli, D., Catani, M., Che Jusoh, A., Chichom Mefire, A., Cocorullo, G., Colak, E., Costa, D., Costa, S., Cui, Y., Curca, G., Curry, T., Das, K., Delibegovic, S., Demetrashvili, Z., Di Carlo, I., Drozdova, N., El Zalabany, T., Enani, M., Faro, M., Gachabayov, M., Giménez Maurel, T., Gkiokas, G., Gomes, C., Gonsaga, R., Guercioni, G., Guner, A., Gupta, S., Gutierrez, S., Hutan, M., Ioannidis, O., Isik, A., Izawa, Y., Jain, S., Jokubauskas, M., Karamarkovic, A., Kauhanen, S., Kaushik, R., Kenig, J., Khokha, V., Kim, J., Kong, V., Koshy, R., Krasniqi, A., Kshirsagar, A., Kuliesius, Z., Lasithiotakis, K., Leão, P., Lee, J., Leon, M., Lizarazu Pérez, A., Lohsiriwat, V., López Tomassetti Fernandez, E., Lostoridis, E., Mn, R., Major, P., Marinis, A., Marrelli, D., Martinez Perez, A., Marwah, S., Mcfarlane, M., Melo, R., Mesina, C., Michalopoulos, N., Moldovanu, R., Mouaqit, O., Munyika, A., Negoi, I., Nikolopoulos, I., Nita, G., Olaoye, I., Omari, A., Ossa, P., Ozkan, Z., Padmakumar, R., Pata, F., Pereira Junior, G., Pereira, J., Pintar, T., Pouggouras, K., Prabhu, V., Rausei, S., Rems, M., Rios Cruz, D., Sakakushev, B., Sánchez de Molina, M., Seretis, C., Shelat, V., Simões, R., Sinibaldi, G., Skrovina, M., Smirnov, D., Spyropoulos, C., Tepp, J., Tezcaner, T., Tolonen, M., Torba, M., Ulrych, J., Uzunoglu, M., van Dellen, D., van Ramshorst, G., Vasquez, G., Venara, A., Vereczkei, A., Vettoretto, N., Vlad, N., Yadav, S., Yilmaz, T., Yuan, K., Zachariah, S., Zida, M., Zilinskas, J., and Ansaloni, L.

Subjects
medicine.medical_specialty, Infections, Intra-abdominal, Sepsis, Septic shock, Ciências da Saúde [Ciências Médicas], Surgery, Emergency Medicine, Ciências Médicas::Ciências da Saúde, Sepsi, medicine.medical_treatment, macromolecular substances, 030230 surgery, GUIDELINES, Likelihood ratios in diagnostic testing, PERITONITIS, 03 medical and health sciences, PROGNOSTIC-FACTORS, 0302 clinical medicine, Internal medicine, Medicine and Health Sciences, MANAGEMENT, medicine, Intra-abdominal Sepsis, Univariate analysis, Science & Technology, COLONIC PERFORATION, Receiver operating characteristic, business.industry, Abdominal Infection, Immunosuppression, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Infections, Intra-abdominal Sepsis, Observational study, Infection, business, SYSTEM, Research Article
Abstract

BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. ----- METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. ----- RESULTS: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p

Published
2015

6. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Author

Salvador Navarro, Giorgio Giraudo, Harry van Goor, Sergio Aloia, Saila Kauhanen, Luca Ansaloni, Miran Rems, Cyrille Huchon, Rodolfo Scibé, Stefano Rausei, Ihor Herych, Damien Massalou, Ferdinando Agresta, Gianluca Guercioni, Fausto Catena, Cristian Mesina, Olivier Pittet, Ionut Negoi, Konstantinos Bouliaris, Cristian Tranà, Elia Poiasina, András Vereczkei, Marco Catani, Jorge Pereira, Mario Dente, Vladimir Khokha, Zoran Krivokapic, Alessandro Ferrero, Daniele Marrelli, Federico Coccolini, Pietro Coletta, Athanasios Marinis, Radu Moldovanu, Dmitry Smirnov, Dimitrios Giakoustidis, Daniel Lazzareschi, Jelena Petrović, Matej Skrovina, Samipetteri Laine, Fabio Cesare Campanile, Ludwig Ney, Martin Hutan, P. Pletinckx, Michele Cucchi, Adam Dziki, Korhan Taviloğlu, Günter Weiss, Mirjami Uotila-Nieminen, Salomone Di Saverio, Pierluigi Viale, Davide Corbella, Avdyl Krasniqi, Dragoljub Zivanovic, Elio Jovine, Piotr Major, Nikola Vladov, Ari Leppäniemi, Nurkan Törer, Sergio Colizza, Carlo De Werra, Charalampos Seretis, Orestis Ioannidis, Nereo Vettoretto, Jaan Tepp, Eliane Angst, Konstantinos Lasithiotakis, Jakub Kenig, Massimo Sartelli, Goran Augustin, Giorgio Vasquez, Helen Tzerbinis, Tadeja Pintar, Miguel Leon, Renato Bessa Melo, Halil Alis, Rafael Díaz-Nieto, Roberto Bini, Boris Sakakushev, David van Dellen, Samir Delibegovic, [Sartelli,M, Lazzareschi,DV, Scibè,R] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena,F, Cucchi,M] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni,L, Coccolini,F, Poiasina,E] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Leppaniemi,A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Taviloglu,K] Department of Surgery, Sisli Florence Nigtingale Hospital, Istanbul, Turkey. [van Goor,H] Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. [Viale,P] Department of Internal Medicine Geriatrics and Nephrologic Diseases, Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy. [Corbela,D] Department of Anestesiology, Ospedali Riuniti, Bergamo, Italy. [de Werra,C, Aloia,S] General, Oncological, Geriatrical Surgery and advanced Technology, University Federico II, Naples, Italy. [Marrelli,D] Department of Human Pathology and Oncology, Policlinico le Scotte, University Hospital, Siena, Italy. [Colizza,S] Department of Surgery, Fatebenefratelli Isola Tiberina hospital, Rome, Italy. [Alis,H] Department of General Surgery, Bakirkoy Training Research Hospital, Istanbul, Turkey. [Torer,N] Department of General Surgery, Baskent University Faculty of Medicine, Adana, Turkey. [Navarro,S] Department of Surgery, Parc Tauli University Hospital, Barcelona, Spain. [Sakakushev,B] First General Surgery Clinic, University Hospital St. George/Chair of Surgical Propedeutics, Medical Faculty, Medical University Plovdiv, Plovdic, Bulgaria. [Massalou,D] Department of Emergency Surgery, University Hospital of Nice, University of Nice Sophia-Antipolis, Sophia-Antipolis, France. [Augustin,G] Department of Surgery, University Hospital Center, Zagreb, Croatia. [Catani,M] Emergency Department, Umberto I Hospital, 'La Sapienza' University of Rome, Rome, Italy. [Kauhanen,S] Department of Gastroenterological surgery Turku, University Central Hospital, Turku, Finland. [Pletinckx,P] Department of Surgery, AZ Maria Middelares, Ghent, Belgium. [Kenig,J] 3rd Department of Generał Surgery, Narutowicz Hospital, Krakow, Połand. [Di Saverio,S, Jovine,E] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Guercioni,G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Skrovina,M] Department of Surgery Hospital and Oncological Centre Novy Jicin, Novy Jicin, Czech republic. [Díaz-Nieto,R] Department of General and Digestive Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Ferrero,A] Department of Surgery, Mauriziano Hospital, Torino, Italy. [Rausei,S] Department of Surgery (Chief Renzo Dionigi), University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. [Laine,S] Department GI-surgery, Kuopio University Hospital, Kuopio, Finland. [Major,P] 2nd Department of Surgery, Jagiellonian University, Krakow, Poland. [Angst,E] Department of Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland. [Pittet,O] Department of Visceral Surgery Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland. [Herych,I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Agresta,F] Department of General Surgery, Ospedale Civile, Adria (RO), Italy. [Vettoretto,N] General and Vascular Surgery, M.Mellini Hospital, Chiari, Italy. [Tepp,J] First General Surgery, North Estonia Regional Hospital, Tallinn, Estonia. [Weiss,G] Intensive Care Klinikum, Magdeburg gGmbH, Magdeburg, Germany. [Vasquez,G] Department of Emergency Surgery Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy. [Vladov,N] Department of Hepato-biliary and Pancreatic surgery and Transplantology, Military Medical Hospital, Sofia, Bulgaria. [Tranà,C] Department of Surgery, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy. [Delivegovic,S] Department of surgery, University Clinic Center Tuzla, Tuzla, Bosnia and Herzegovina. [Dziki,A] Department of General and Colorectal Surgery, University Hospital, Central Veterans Hospital, Lodz, Poland. [Giraudo,G] Surgical Department Santa Croce e Carle hospital, Cuneo, Italy. [Pereira,J] Department of Surgery, São Teotónio Hospital, Viseu, Portugal. [Tzerbinis,H] Department of HPB and Liver Transplant Surgery, Royal Free Hospital, London, United Kingdom. [van Dellen,D] Department of Surgery, Manchester Royal Infirmare, Manchester, UK. [Hutan,M] IInd Surgical department of Medical faculty Comenius University, University Hospital Bratislava, st. Cyril and Methodius Hospital, Bratislava, Slovakia. [Vereczkei,A] Department of Surgery, Medical School University of Pécs, Pécs, Hungary. [Krasniqi,A] Department of Abdominal Surgery, University Clinical Centre of Kosovo, Prishtina, Kosovo. [Seretis,Ch] 2nd Department of Surgery, General Army Hospital of Athens, Athens, Greece. [Mesina,C] Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Roumanie. [Rems,M] Surgical Department, General hospital Jesenice, Jesenice, Slovenia. [Campanile,FC] Department of surgery, Andosilla Hospital, Civita Castellana, Italy. [Coletta,P] Department of Surgery, Jesi Hospital, Jesi, Italy. [Uotila-Nieminen,M] Department of Gastrointestinal Surgery, North Carelian Central Hospital, Joensuu, Finland. [Dente,M] Oncologic, Digestive and Emergency Surgery, Bocage Hospital, Dijon, France. [Bouliaris,K] Surgical Department General Hospital of Larissa, Larissa, Greece. [Lasithiotakis,K] Department of General Surgery, University Hospital of Heraklion, Heraklion, Greece. [KhoKha,V] Surgical Department, Mozyr, Belarus. [Zivanovic,D] Department of Pediatric surgery, Paediatric surgery and orthopaedic Clinic, Nis, Serbia. [Smirnov,D] General Surgery, Clinical Hospital at Chelyabinsk Station OJSC 'Russian Railroads', Chelyabinsk City, Russian Federation. [Marinis,A] First Department of Surgery, Tzanion General Hospital, Piraeus, Greece. [Negoi,I] Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania. [Ney,L] Deparment of Surgery, Downtown Campus, University Hospital of Munich, Munich, Germany. [Bini,R] General and emergency surgery, SG Bosco Hospital, Torino, Italy. [León,M] Department of General Surgery, Hospital La Paz, Madrid, Spain. [Huchon,C] Department of Gynecology and Obstetrics, CHI Poissy-St-Germain-En-Laye, France and University Versailles Saint-Quentin, Versailles, France. [Moldovanu,R] Chirurgie Viscerale, Digestive et Oncologique Hospital Prive, Arras les Bonnettes, Arras, France. [de Melo,RB] Department of General Surgery, Hospital São João Porto, Porto, Portugal. [Giakoustidis,D] Division of Transplantation, Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece. [Ioannidis,O] 1st Surgical Department, General Regional Hospital 'George Papanikolaou', Thessaloniki, Greece. [Pintar,T] Department of Abdominal Surgery, umc Ljubljana, Ljubljana, Slovenia. [Krivokapic,Z, Petrovic,J] First Surgical clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade 8, Belgrade, Serbia., and II kirurgian klinikka

Subjects
Infecciones Intraabdominales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], 030230 surgery, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drainage [Medical Subject Headings], Abceso Abdominal, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], 0302 clinical medicine, Epidemiology, Farmacoresistencia Microbiana, Medicine, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], PRIMARY ANASTOMOSIS, Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Adulto, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Diverticulitis, 3. Good health, Humanos, Procedimientos Quirúrgicos del Sistema Digestivo, 030220 oncology & carcinogenesis, Emergency Medicine, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings], Research Article, medicine.medical_specialty, Perforation (oil well), education, Infección Hospitalaria, lcsh:Surgery, APPENDECTOMY, Enfermedad Crítica, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], Sepsis, 03 medical and health sciences, Internal medicine, HARTMANNS PROCEDURE, MANAGEMENT, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Estudio Multicéntrico, Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], business.industry, Septic shock, Abdominal Infection, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, PRIMARY RESECTION, Emergency medicine, Observational study, Surgery, business, DIVERTICULITIS
Abstract

The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

Published
2012

7. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study).

Author

Sartelli M, Abu-Zidan FM, Catena F, Griffiths EA, Di Saverio S, Coimbra R, Ordoñez CA, Leppaniemi A, Fraga GP, Coccolini F, Agresta F, Abbas A, Abdel Kader S, Agboola J, Amhed A, Ajibade A, Akkucuk S, Alharthi B, Anyfantakis D, Augustin G, Baiocchi G, Bala M, Baraket O, Bayrak S, Bellanova G, Beltràn MA, Bini R, Boal M, Borodach AV, Bouliaris K, Branger F, Brunelli D, Catani M, Che Jusoh A, Chichom-Mefire A, Cocorullo G, Colak E, Costa D, Costa S, Cui Y, Curca GL, Curry T, Das K, Delibegovic S, Demetrashvili Z, Di Carlo I, Drozdova N, El Zalabany T, Enani MA, Faro M, Gachabayov M, Giménez Maurel T, Gkiokas G, Gomes CA, Gonsaga RA, Guercioni G, Guner A, Gupta S, Gutierrez S, Hutan M, Ioannidis O, Isik A, Izawa Y, Jain SA, Jokubauskas M, Karamarkovic A, Kauhanen S, Kaushik R, Kenig J, Khokha V, Kim JI, Kong V, Koshy R, Krasniqi A, Kshirsagar A, Kuliesius Z, Lasithiotakis K, Leão P, Lee JG, Leon M, Lizarazu Pérez A, Lohsiriwat V, López-Tomassetti Fernandez E, Lostoridis E, Mn R, Major P, Marinis A, Marrelli D, Martinez-Perez A, Marwah S, McFarlane M, Melo RB, Mesina C, Michalopoulos N, Moldovanu R, Mouaqit O, Munyika A, Negoi I, Nikolopoulos I, Nita GE, Olaoye I, Omari A, Ossa PR, Ozkan Z, Padmakumar R, Pata F, Pereira Junior GA, Pereira J, Pintar T, Pouggouras K, Prabhu V, Rausei S, Rems M, Rios-Cruz D, Sakakushev B, Sánchez de Molina ML, Seretis C, Shelat V, Simões RL, Sinibaldi G, Skrovina M, Smirnov D, Spyropoulos C, Tepp J, Tezcaner T, Tolonen M, Torba M, Ulrych J, Uzunoglu MY, van Dellen D, van Ramshorst GH, Vasquez G, Venara A, Vereczkei A, Vettoretto N, Vlad N, Yadav SK, Yilmaz TU, Yuan KC, Zachariah SK, Zida M, Zilinskas J, and Ansaloni L

Abstract

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression., Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study., Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4., Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

Published
2015
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8. A proposal for a CT driven classification of left colon acute diverticulitis.

Author

Sartelli M, Moore FA, Ansaloni L, Di Saverio S, Coccolini F, Griffiths EA, Coimbra R, Agresta F, Sakakushev B, Ordoñez CA, Abu-Zidan FM, Karamarkovic A, Augustin G, Costa Navarro D, Ulrych J, Demetrashvili Z, Melo RB, Marwah S, Zachariah SK, Wani I, Shelat VG, Kim JI, McFarlane M, Pintar T, Rems M, Bala M, Ben-Ishay O, Gomes CA, Faro MP, Pereira GA Jr, Catani M, Baiocchi G, Bini R, Anania G, Negoi I, Kecbaja Z, Omari AH, Cui Y, Kenig J, Sato N, Vereczkei A, Skrovina M, Das K, Bellanova G, Di Carlo I, Segovia Lohse HA, Kong V, Kok KY, Massalou D, Smirnov D, Gachabayov M, Gkiokas G, Marinis A, Spyropoulos C, Nikolopoulos I, Bouliaris K, Tepp J, Lohsiriwat V, Çolak E, Isik A, Rios-Cruz D, Soto R, Abbas A, Tranà C, Caproli E, Soldatenkova D, Corcione F, Piazza D, and Catena F

Abstract

Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.

Published
2015
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9. Impartial long-term review of vertical banded gastroplasty in a low volume community hospital practice.

Author

Voitk A, Tepp J Jr, and Joffe J

Subjects
Adult, Body Mass Index, Female, Follow-Up Studies, Gastroplasty methods, Hernia, Ventral epidemiology, Hernia, Ventral etiology, Humans, Male, Patient Satisfaction, Quality of Life, Retrospective Studies, Surveys and Questionnaires, Gastroplasty statistics & numerical data, Hospitals, Community statistics & numerical data, Obesity, Morbid surgery, Postoperative Complications epidemiology
Abstract

Background: There is some concern whether bariatric surgery can be done well at low volumes or in a community hospital setting. This paper reports an impartial assessment of 25 vertical banded gastroplasties (VBG) over 13 years in a 228-bed non-teaching community hospital., Methods: Charts were reviewed and patients interviewed by an independent investigator. Complications, weight loss, satisfaction and quality of life were assessed., Results: There were no fatalities, no splenic tears, no stomal stenosis and no symptomatic gastroesophageal reflux. Two reoperations and five incisional hernias were noted. Hypertension was eliminated in 57% and dyspnea in 55%. BMI fell from 44.3 to 34.9 kg/m2 after 6.2 years. BMI decreased more than 10 kg/m2 (10-30) for 15 patients and less than 10 kg/m2 for 10 patients (4-10 for 7, 0 for 1 and a gain for 2). 56% of patients were fully satisfied with the results. Quality of life indicated excellent physical function, physical role and lack of body pain, good general health, social function, emotional role and mental health, but lower vitality. 100% felt better than a year ago., Conclusion: Results from a low-volume community hospital general surgical practice are similar to those from specialized series. Obesity is so common, its non-surgical treatment so ineffective and the VBG so well established, that excluding this intervention from community hospitals is untenable.

Published
2001
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10. Hip fracture as a complication of hospitalization.

Author

Tepp J and Voitk A

Subjects
Aged, Health Services Misuse, Hip Fractures etiology, Humans, Iatrogenic Disease epidemiology, Needs Assessment, Ontario epidemiology, Retrospective Studies, Risk Factors, Risk Management, Accidental Falls statistics & numerical data, Hip Fractures epidemiology, Hospitalization statistics & numerical data, Inpatients statistics & numerical data, Utilization Review
Abstract

This work seeks to assess the possible contribution of hospitalization to hip fractures sustained in an acute care hospital and to determine the need for hospital care for these patients at the time of the fracture. Between 1988 and 1997 there was an average of 399 falls and four in-hospital hip fractures per year. For 14 percent, no predisposing factors for falling were noted, 38 percent of the fractures occurred within the first three days and 47 percent during the first week of hospitalization. Original admission did not seem warranted for 10 percent and 48 percent no longer required inpatient care at the time of the fracture. Most fractures occur early during hospitalization; some patients seem to have no predisposing factors for falling and about one-half may not require hospitalization at the time, all implicating hospitalization as a causative factor.

Published
1999
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