{Reference Type}: Journal Article
{Title}: Importance of Source Control in the Subgroup of Intra-Abdominal Infections for Septic Shock Patients: Analysis of 390 Cases.
{Author}: Önal U;Akyol Seyhan D;Ketenoğlu OB;Mert Vahabi M;Başkol Elik D;Memetali SC;Şanlıdağ İşbilen G;Bulut Avşar C;Kaya A;Uyan-Önal A;Yalçın N;Guliyeva G;Dirik Ş;Acet O;Akdağ D;Görür MD;Bozbıyık O;Göktepe B;Gümüş T;Çankayalı İ;Demirağ K;Uyar M;Sipahi H;Erdem HA;Işıkgöz Taşbakan M;Arda B;Aydemir Ş;Ulusoy S;Sipahi OR;
{Journal}: Mediterr J Hematol Infect Dis
{Volume}: 16
{Issue}: 1
{Year}: 2024
{Factor}: 3.122
{DOI}: 10.4084/MJHID.2024.051
{Abstract}: UNASSIGNED: This study aimed to evaluate the epidemiology of septic shock (SS) associated with intraabdominal infections (IAI) as well as associated mortality and efficacy of early source control in a tertiary-care educational hospital.
UNASSIGNED: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 during night shifts in our centre were analyzed retrospectively.
UNASSIGNED: A total number of 390 patients were included. Overall, 30-day mortality was 42.5% on day 3, while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%), and the mortality rate was significantly lower in cases that were performed source control at any time during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%), source control was performed during the first 12 hours, and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)= 2.943, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.179-4.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA≥10 (p<0.001, OR=3.036, 95%CI=1.802-5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with 30-day mortality in logistic regression analysis.
UNASSIGNED: Source control has a vital importance in terms of mortality rates for IAI-related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.