| Autor: |
Park JY; Department of Surgery, Gangneung Asan Hospital, Gangneung, South Korea., Yang KM; Department of Surgery, Gangneung Asan Hospital, Gangneung, South Korea.; Department of Surgery, University of Ulsan College of Medicine, Ulsan, South Korea., Kwak JY; Department of Surgery, Gangneung Asan Hospital, Gangneung, South Korea.; Department of Surgery, University of Ulsan College of Medicine, Ulsan, South Korea., Jung YT; Department of Surgery, Gangneung Asan Hospital, Gangneung, South Korea.; Department of Surgery, University of Ulsan College of Medicine, Ulsan, South Korea. |
| Jazyk: |
angličtina |
| Zdroj: |
Surgical infections [Surg Infect (Larchmt)] 2024 May; Vol. 25 (4), pp. 307-314. Date of Electronic Publication: 2024 Apr 17. |
| DOI: |
10.1089/sur.2023.333 |
| Abstrakt: |
Background: Candida species account for approximately 15% of hospital-associated infections, causing fatal consequences, especially in critically ill patients. This study aimed to evaluate invasive candidiasis (IC) risk factors in critically ill patients undergoing surgery. Patients and Methods: We retrospectively reviewed the medical records of 583 patients who underwent emergency surgery for complicated intra-abdominal infections between January 2016 and December 2021. Patients were divided into two groups according to the presence or absence of IC during their hospital stay. IC was defined as culture-proven candidemia and intra-abdominal candidiasis. Results: This study included 373 patients for the final analysis, of whom 320 were discharged without IC (IC absent group) and 53 presented with IC (IC present group) during their hospital stay. The IC present group showed a higher in-hospital mortality rate (35.8 vs. 8.8%; p < 0.001), with 66.0% of the patients diagnosed within 10 days, whereas only 6.5% were diagnosed beyond 20 days after admission. Stomach (odds ratio [OR], 4.188; 95% confidence interval [CI], 1.204-14.561; p = 0.024) and duodenum (OR, 7.595; 95% CI, 1.934-29.832; p = 0.004) as infection origin, higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR, 1.097; 95% CI, 1.044-1.152; p < 0.001), and lower initial systolic blood pressure (OR, 0.983; 95% CI, 0.968-0.997; p = 0.018) were risk factors of IC after emergency gastrointestinal surgery. Conclusions: Patients who had stomach and duodenum as infection origin, higher APACHE II scores, and lower initial systolic blood pressure had a higher risk of developing IC during their hospital stay after emergency gastrointestinal surgery. Prophylactic antifungal agents can be carefully considered for critically ill patients with these features. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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