Key result
Application of WSES guidelines for the management of intra-abdominal infections significantly reduced in-hospital mortality from 3.2% to 1.1% and morbidity from 22.7% to 10.2%.
Why the study?
Does the application of WSES guidelines reduce morbidity, mortality, and costs in patients with acute intra-abdominal infections?
Observational (n=2,121)
No
Does the application of WSES guidelines reduce morbidity, mortality, and costs in patients with acute intra-abdominal infections?
The application of WSES guidelines for intra-abdominal infections significantly reduced in-hospital morbidity, mortality, and antibiotic costs.
Answers are grounded in this paper and cite their sources.
Associated with lower mortality in intra-abdominal infections; leaves open need for randomized confirmation before practice change.
INTRODUCTION: The use of antibiotics is very high in the departments of Emergency and Trauma Surgery above all in the treatment of the intra-abdominal infections, to decrease morbidity and mortality rates; often the antimicrobial drugs are prescribed without a rationale and they are second-line antibiotics; this clinical practice increases costs without decreasing mortality. Aim of our study is to report the results in the application to the clinical practice of the World Society Emergency Surgeons (WSES) guidelines for the management of intra-abdominal infections, at the department of Emergency and Trauma Surgery of the University Hospital of Parma (Italy) in 2012. METHODS: A retrospective observational analysis was carried out about patients admitted in the department of Emergency and Trauma Surgery of Parma (Italy), between January 2011 and December 2012. The data are expressed as percentages (%) and means (± SD). The results of the compared groups were analyzed using the Pearson's Chi-Square and Fisher's tests. For means involving continuous numerical data, the independent sample T test and the Mann-Whitney U-test were used for normally and abnormally distributed data, respectively (the data had been previously tested for normality using the Kolmogorov-Smirnov test). A p-value < 0.05 was considered statistically significant. RESULTS: Between January 2011 and December 2012, 2121 (968 in 2011 and 1153 in 2012) patients were admitted in the department of Emergency and Trauma Surgery (Italy) of Parma University Hospital with a diagnosis of acute IAI. Morbidity in 2012 was 10,2% compared to 22.7% in 2011 and mortality in 2012 was 1,1% compared to 3,2% in 2011 (p < 0,05). Costs for antibiotics in 2012 was 51392 euro, with a reduction of 31% compared to 2011. CONCLUSIONS: This study demonstrates that an inexpensive and easily application of guidelines based on medicine evidence in the use of antibiotics can lead to a significative reduction of hospital costs with outcomes improvement.
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Simone et al. (2015) conducted an observational in Acute intra-abdominal infections (n=2,121). WSES guidelines application vs. Standard care without guidelines (2011 cohort) was evaluated on In-hospital mortality (p=<0.05). Application of WSES guidelines for the management of intra-abdominal infections significantly reduced in-hospital mortality from 3.2% to 1.1% and morbidity from 22.7% to 10.2%.
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