Age and its impact on outcomes with intra-abdominal infection

Drew Farmer, Jeffrey M. Tessier, James M. Sanders, Robert G. Sawyer, Ori D. Rotstein, E. P. Dellinger, Pamela A Lipsett, Joseph Cuschieri, Preston Miller, Charles H. Cook, Christopher A. Guidry, Reza Askari, Billy J. Moore, Therese M. Duane

Research output: Contribution to journalArticle

Abstract

Background: Age has been shown to play a significant role in the etiology of complicated intra-abdominal infections (cIAIs), but the correlation between age and outcomes after therapy was not investigated in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial. Patients and Methods: Data were obtained by post hoc analysis of the STOP-IT trial database. Patients were stratified by age <65 or =65 years. Primary outcomes were surgical site infection (SSI), recurrent IAI (recIAI), and death. Multivariable analysis was performed to identify independent predictors of outcomes. Results: There were 398 subjects <65 and 120 = 65 years. Overall baseline characteristics of the two groups were similar. The site of infection was similar between groups except: Colon or rectum (48.3% vs. 29.9%, p = 0.0002) and biliary tree (16.7% vs. 9.1%, p = 0.02), which were more common in the older group, whereas small intestine (6.7% vs. 16.3%, p = 0.008) and appendix (4.2% vs.17.1%, p = 0.0004) were more common in the younger group. Among the primary outcomes, only death was significantly different between the age groups and was more prevalent in the =65 years group (4 [3.3%] vs. 1 [0.3%], p = 0.01). Surgical site infection (9.2% vs. 7.3%, p = 0.50), recIAI (15.8% vs. 14.4%, p = 0.69), and a composite outcome (26.7% vs. 20.4%, p = 0.14) were statistically similar between the age groups, and this remained true when controlling for other co-variables. Multivariable analyses did not reveal age as an independent predictor of the composite or individual outcomes. Conclusion: Patients with a more advanced age demonstrated variable sources of infection relative to the younger cohort, yet received similar treatments. Patient age was not an independent predictor of the undesired cIAI outcomes. These findings suggest that advanced age itself does not play a significant role in predicting these adverse outcomes for cIAIs and does not necessitate an altered treatment tactic.

Original languageEnglish (US)
Pages (from-to)77-82
Number of pages6
JournalSurgical Infections
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2017

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Intraabdominal Infections
Surgical Wound Infection
Infection
Age Groups
Therapeutics
Appendix
Biliary Tract
Rectum
Small Intestine
Colon
Databases

Keywords

  • abdominal infection
  • antibiotic prophylaxis
  • antibiotic therapy
  • clinical trial
  • sepsis

ASJC Scopus subject areas

  • Surgery
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Farmer, D., Tessier, J. M., Sanders, J. M., Sawyer, R. G., Rotstein, O. D., Dellinger, E. P., ... Duane, T. M. (2017). Age and its impact on outcomes with intra-abdominal infection. Surgical Infections, 18(2), 77-82. https://doi.org/10.1089/sur.2016.184

Age and its impact on outcomes with intra-abdominal infection. / Farmer, Drew; Tessier, Jeffrey M.; Sanders, James M.; Sawyer, Robert G.; Rotstein, Ori D.; Dellinger, E. P.; Lipsett, Pamela A; Cuschieri, Joseph; Miller, Preston; Cook, Charles H.; Guidry, Christopher A.; Askari, Reza; Moore, Billy J.; Duane, Therese M.

In: Surgical Infections, Vol. 18, No. 2, 01.02.2017, p. 77-82.

Research output: Contribution to journalArticle

Farmer, D, Tessier, JM, Sanders, JM, Sawyer, RG, Rotstein, OD, Dellinger, EP, Lipsett, PA, Cuschieri, J, Miller, P, Cook, CH, Guidry, CA, Askari, R, Moore, BJ & Duane, TM 2017, 'Age and its impact on outcomes with intra-abdominal infection', Surgical Infections, vol. 18, no. 2, pp. 77-82. https://doi.org/10.1089/sur.2016.184
Farmer D, Tessier JM, Sanders JM, Sawyer RG, Rotstein OD, Dellinger EP et al. Age and its impact on outcomes with intra-abdominal infection. Surgical Infections. 2017 Feb 1;18(2):77-82. https://doi.org/10.1089/sur.2016.184
Farmer, Drew ; Tessier, Jeffrey M. ; Sanders, James M. ; Sawyer, Robert G. ; Rotstein, Ori D. ; Dellinger, E. P. ; Lipsett, Pamela A ; Cuschieri, Joseph ; Miller, Preston ; Cook, Charles H. ; Guidry, Christopher A. ; Askari, Reza ; Moore, Billy J. ; Duane, Therese M. / Age and its impact on outcomes with intra-abdominal infection. In: Surgical Infections. 2017 ; Vol. 18, No. 2. pp. 77-82.
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abstract = "Background: Age has been shown to play a significant role in the etiology of complicated intra-abdominal infections (cIAIs), but the correlation between age and outcomes after therapy was not investigated in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial. Patients and Methods: Data were obtained by post hoc analysis of the STOP-IT trial database. Patients were stratified by age <65 or =65 years. Primary outcomes were surgical site infection (SSI), recurrent IAI (recIAI), and death. Multivariable analysis was performed to identify independent predictors of outcomes. Results: There were 398 subjects <65 and 120 = 65 years. Overall baseline characteristics of the two groups were similar. The site of infection was similar between groups except: Colon or rectum (48.3{\%} vs. 29.9{\%}, p = 0.0002) and biliary tree (16.7{\%} vs. 9.1{\%}, p = 0.02), which were more common in the older group, whereas small intestine (6.7{\%} vs. 16.3{\%}, p = 0.008) and appendix (4.2{\%} vs.17.1{\%}, p = 0.0004) were more common in the younger group. Among the primary outcomes, only death was significantly different between the age groups and was more prevalent in the =65 years group (4 [3.3{\%}] vs. 1 [0.3{\%}], p = 0.01). Surgical site infection (9.2{\%} vs. 7.3{\%}, p = 0.50), recIAI (15.8{\%} vs. 14.4{\%}, p = 0.69), and a composite outcome (26.7{\%} vs. 20.4{\%}, p = 0.14) were statistically similar between the age groups, and this remained true when controlling for other co-variables. Multivariable analyses did not reveal age as an independent predictor of the composite or individual outcomes. Conclusion: Patients with a more advanced age demonstrated variable sources of infection relative to the younger cohort, yet received similar treatments. Patient age was not an independent predictor of the undesired cIAI outcomes. These findings suggest that advanced age itself does not play a significant role in predicting these adverse outcomes for cIAIs and does not necessitate an altered treatment tactic.",
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AU - Farmer, Drew

AU - Tessier, Jeffrey M.

AU - Sanders, James M.

AU - Sawyer, Robert G.

AU - Rotstein, Ori D.

AU - Dellinger, E. P.

AU - Lipsett, Pamela A

AU - Cuschieri, Joseph

AU - Miller, Preston

AU - Cook, Charles H.

AU - Guidry, Christopher A.

AU - Askari, Reza

AU - Moore, Billy J.

AU - Duane, Therese M.

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N2 - Background: Age has been shown to play a significant role in the etiology of complicated intra-abdominal infections (cIAIs), but the correlation between age and outcomes after therapy was not investigated in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial. Patients and Methods: Data were obtained by post hoc analysis of the STOP-IT trial database. Patients were stratified by age <65 or =65 years. Primary outcomes were surgical site infection (SSI), recurrent IAI (recIAI), and death. Multivariable analysis was performed to identify independent predictors of outcomes. Results: There were 398 subjects <65 and 120 = 65 years. Overall baseline characteristics of the two groups were similar. The site of infection was similar between groups except: Colon or rectum (48.3% vs. 29.9%, p = 0.0002) and biliary tree (16.7% vs. 9.1%, p = 0.02), which were more common in the older group, whereas small intestine (6.7% vs. 16.3%, p = 0.008) and appendix (4.2% vs.17.1%, p = 0.0004) were more common in the younger group. Among the primary outcomes, only death was significantly different between the age groups and was more prevalent in the =65 years group (4 [3.3%] vs. 1 [0.3%], p = 0.01). Surgical site infection (9.2% vs. 7.3%, p = 0.50), recIAI (15.8% vs. 14.4%, p = 0.69), and a composite outcome (26.7% vs. 20.4%, p = 0.14) were statistically similar between the age groups, and this remained true when controlling for other co-variables. Multivariable analyses did not reveal age as an independent predictor of the composite or individual outcomes. Conclusion: Patients with a more advanced age demonstrated variable sources of infection relative to the younger cohort, yet received similar treatments. Patient age was not an independent predictor of the undesired cIAI outcomes. These findings suggest that advanced age itself does not play a significant role in predicting these adverse outcomes for cIAIs and does not necessitate an altered treatment tactic.

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