| アブストラクト | BACKGROUND: The benefit of taking intra-abdominal cultures during source control procedures in patients with complicated intra-abdominal infection (CIAI) is unknown. The aim of this study was to evaluate whether intra-abdominal cultures reduce the mortality rate of CIAI. METHODS: The Japanese Diagnosis Procedure Combination database was used to identify adult patients with CIAI who had undergone source control procedures on the first day of admission to hospital between April 2014 and March 2016. In-hospital mortality was compared between patients who did and those who did not have intra-abdominal cultures taken. A generalized linear mixed-effect logistic regression model and a random intercept per hospital were used to adjust for baseline confounders and institutional differences. Subgroup analyses were also performed according to disease cause, site of onset and severity of CIAI. RESULTS: Intra-abdominal cultures were taken from 16 303 of 41 495 included patients. Multivariable logistic regression analysis showed that patients with intra-abdominal cultures had a significantly lower mortality than those without (odds ratio 0.85, 95 per cent c.i. 0.77 to 0.95). Subgroup analyses revealed statistically significant differences in mortality between patients with and without cultures among those with lower intestinal perforation, biliary tract infection/perforation, healthcare-associated CIAI and high-risk community-acquired CIAI. CONCLUSIONS: Intra-abdominal cultures obtained during source control procedures may reduce in-hospital mortality, especially in patients with lower intestinal perforation, biliary tract infection/perforation, or healthcare-associated or high-risk community-acquired CIAI. |
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| ジャーナル名 | The British journal of surgery |
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| 投稿日 | 2019/3/19 |
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| 投稿者 | Tsuchiya, A; Yasunaga, H; Tsutsumi, Y; Kawahara, T; Matsui, H; Fushimi, K |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, University of Tokyo, Tokyo, Japan.;Department of Emergency and Critical Care Medicine, National Hospital;Organization Mito Medical Centre, Ibaraki, Japan.;Biostatistics Division, Central Coordinating Unit, Clinical Research Support;Centre, University of Tokyo Hospital, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30883708/ |
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