Langenbeck's Archives of Surgery

, Volume 384, Issue 1, pp 24–32 | Cite as

Risk factors associated with intraabdominal infections: a prospective multicenter study

  • H. Wacha
  • T. Hau
  • R. Dittmer
  • C. Ohmann
  • and the Peritonitis Study Group
ORIGINAL ARTICLE

Abstract

Introduction and methods: A prospective observational multicenter study with 18 hospitals was performed to assess preoperative risk, therapeutic management and outcome of patients with peritonitis. Data collection was carried out according to standardized and recommended definitions. Included in the study were 355 patients with macroscopically confirmed peritonitis. Results: In the univariate analysis, the following factors influenced both the mortality and the incidence of postoperative complications: age, presence of certain concomitant disease, site of origin of peritonitis, type of admission and the ability of the surgeon to eliminate the source of infection. In addition, postoperative infective complications were related to the etiology of peritonitis and the exudate. In the multivariate analysis, APACHE II (P<0.001), successful operation (P<0.001), age (P<0.001), liver disease (P<0.03), malignant disease (P<0.04) and renal disease (P<0.05) turned out to be significant with respect to death. Escherichia coli was the predominant organism (51%), following by enterococci (30%) and bacteroides (25%). There was a significantly higher postoperative infection rate in patients with no adequate treatment of enterococci than patients with adequate treatment or no enterococci (P<0.05). Conclusion: The study demonstrated the important role of the physiological reserve of the patient and of the surgeon, which is not adequately reflected in existing scoring systems. Further investigations are needed to study the impact of enterococci on the outcome.

Key words Intraabdominal infection Prognosis Prospective study Risk factor 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • H. Wacha
    • 1
  • T. Hau
    • 2
  • R. Dittmer
    • 3
  • C. Ohmann
    • 3
  • and the Peritonitis Study Group
  1. 1.Chirurgische Klinik, Hospital zum heiligen Geist, Academic Hospital of the University of Frankfurt, Langestr. 4–6, D-60311 Frankfurt, Germany, Tel.: +49-69-2196430, Fax: +49-69-21962506DE
  2. 2.Nordwestkrankenhaus Sanderbusch, Chirurgische Abteilung, D-26452 Sande, GermanyDE
  3. 3.Theoretical Surgery Unit, Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, GermanyDE

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