Risk factors for anastomotic leakage and favorable antimicrobial treatment as empirical therapy for intra-abdominal infection in patients undergoing colorectal surgery

Surgery Today ◽  
2013 ◽  
Vol 44 (3) ◽  
pp. 487-493 ◽  
Author(s):  
Minako Kobayashi ◽  
Yasuhiko Mohri ◽  
Masaki Ohi ◽  
Yasuhiro Inoue ◽  
Toshimitsu Araki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Empirical Therapy ◽  
Antimicrobial Treatment ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

scholarly journals Risk factors for developing high-output ileostomy in CRC patients: a retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongxiao Bai ◽  
Lei Li ◽  
Zhiling Shen ◽  
Tianchen Huang ◽  
Qingbing Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Multivariate Analysis ◽  
Anastomotic Leakage ◽  
Bowel Disease ◽  
Total Colectomy ◽  
Abdominal Infection ◽  
Inflammatory Bowel ◽  
High Output

Abstract Background Anastomotic leakage is one of the most serious postoperative complications of rectal cancer. Prophylactic ileostomy has been widely used to reduce the risk and severity of complications of anastomotic leakage. However, prophylactic ileostomy itself has some complications, and ileostomy high output syndrome (HOS) is one of them. This study was performed to explore the risk factors of HOS in ileostomy. Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last 5 years. The relationship between HOS and the clinicopathological data was analyzed using the Chi-square test and Fisher’s exact probability. Multivariate analysis was performed by logistic regression. Results The incidence of HOS was 23.07% in this study. Dehydration was the most common symptom of HOS (37.7%). There was no clear correlation between HOS occurrence with sex, age, gross typing, histological grade, tumor location, lymph node metastasis, and TNM stage (p > 0.05). The incidence of HOS was 14/18 in inflammatory bowel disease patients, 18/28 in diabetes mellitus patients, and 23/72 in neoadjuvant chemoradiotherapy patients, 13/17 in total colectomy and abdominal infection patients. Multivariate analysis showed that they are risk factors for HOS (p < 0.05). Conclusion HOS occurred occasionally but rarely studied and lacks attention. Inflammatory bowel disease, diabetes mellitus, neoadjuvant radiotherapy chemotherapy, total colectomy and abdominal infection are the risk factors for HOS.

Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection

2016 ◽  
Vol 82 (9) ◽  
pp. 860-866 ◽  
Author(s):  
Rishi Rattan ◽  
Casey J. Allen ◽  
Robert G. Sawyer ◽  
John Mazuski ◽  
Therese M. Duane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Surgical Site Infection ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Site Infection ◽  
Chronic Health ◽  
Abdominal Infection ◽  
Short Course ◽  
Intra Abdominal Infection

A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intraabdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

Smoking and alcohol misuse are major risk factors of anastomotic leakage in colorectal surgery

1998 ◽  
Vol 114 ◽  
pp. A43 ◽  
Author(s):  
L.T. Sørensen ◽  
L.T. Kirkeby ◽  
J. Skovdal ◽  
B. Vennits ◽  
P. Wille-Jørgensen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Alcohol Misuse

scholarly journals Assessment of mortality-related risk factors and effective antimicrobial regimens for the treatment of bloodstream infections caused by carbapenem-resistant Enterobacterales

2021 ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
YanLi Li
Keyword(s):  
Risk Factors ◽  
Mortality Risk ◽  
Empirical Therapy ◽  
Bloodstream Infections ◽  
Antimicrobial Treatment ◽  
Source Control ◽  
Teaching Hospitals ◽  
Treatment Regimens ◽  
Carbapenem Resistant ◽  
Related Risk

Abstract Background Bloodstream infections (BSIs) attributable to carbapenem-resistant Enterobacterales (CRE-BSIs) are dangerous and a major cause of mortality in clinical settings. This study was therefore designed to define risk factors linked to 30-day mortality in CRE-BSI patients and to examine the relative efficacy of different antimicrobial treatment regimens in affected individuals. Methods Data pertaining to 187 CRE-BSI cases from three teaching hospitals in China collected between January 2018 and June 2020 were retrospectively analyzed. Results For the 187 analyzed patients in this study, the 30-day mortality of CRE-BSI was 41.7% (78/187). Multivariate logistic regression analyses revealed that Pitt score [odd ratio (OR) 5.313, 95% confidence interval (CI) 3.209–8.797, P < 0.001], immunocompromised status (OR 4.605, 95% CI 1.629–13.020, P = 0.004), meropenem minimum inhibitory concentration (MIC) ≥ 8 mg/L (OR 3.736, 95% CI 1.091–12.795, P = 0.036), source control of infection (OR 0.316, 95% CI 0.117–0.854, P = 0.023), and appropriate empirical therapy (OR 0.129, 95% CI 0.027–0.625, P = 0.011) were independent predictors of CRE-BSI patient 30-day mortality. After controlling for potential confounding factors, relative to ceftazidime-avibactam (CAZ-AVI) treatment, combination therapies including CAZ-AVI (OR 1.287, 95% CI 0.124–13.403, P = 0.833) were not related to any significant change in patient mortality risk, whereas 30-day mortality risk was higher for patients administered other antimicrobial regimens (OR 12.407, 95% CI 1.684–31.430, P = 0.011). When patients were treated with antimicrobial regimens not containing CAZ-AVI, combination therapy (OR 0.239, 95% CI 0.077–0.741, P = 0.013) was related to a decreased 30-day mortality risk relative to monotherapy treatment. Conclusion The mortality-related risk factors and relative antimicrobial regimen efficacy data demonstrated in this study may guide the management of CRE-BSI patients.

scholarly journals Complicated intra-abdominal infection at multidisciplinary hospital: economics of real practice of antimicrobial treatment

2018 ◽  
Vol 6 (1) ◽  
pp. 10-20
Author(s):  
Yu.M. Gomon ◽  
A.S. Kolbin ◽  
Yu.E. Balykina ◽  
M.A. Arepiyeva ◽  
S.V. Sidorenko ◽  
...  
Keyword(s):  
Antimicrobial Treatment ◽  
Abdominal Infection ◽  
Hospital Economics ◽  
Intra Abdominal Infection ◽  
Real Practice
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