Impact of Early Surgical Debridement on Outcomes in ICU Patients With Sepsis-Associated Intra-Abdominal Infection: A Retrospective Analysis.

IF 0.8 4区医学 Q3 SURGERY

Annali italiani di chirurgia Pub Date : 2026-08-13 DOI:10.62713/aic.4619

Jiaolong He, Wenjun Li, Haodong Wang

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引用次数: 0

Abstract

Aim: To investigate the impact of early surgical debridement, defined as a diagnosis-to-knife time (D-to-K time) ≤12 hours, on intensive care unit (ICU) outcomes in patients with sepsis-associated intra-abdominal infection.

Methods: This single-center retrospective cohort study consecutively enrolled patients with sepsis-associated intra-abdominal infection who were admitted to the ICU and underwent surgical debridement between 1 January 2021 and 31 January 2025. Patients were stratified into an early surgery group (D-to-K time ≤12 hours, n = 65) and a delayed surgery group (D-to-K time >12 hours, n = 87). Baseline characteristics, ICU length of stay, duration of organ support, incidence of complications, mortality and other clinical outcomes were compared between the two groups. Multivariate logistic regression analysis was performed to evaluate the independent effect of early surgery on 28-day mortality.

Results: The delayed surgery group demonstrated a higher prevalence of preoperative septic shock (66.7% vs. 33.8%) and diffuse peritonitis (50.6% vs. 32.3%), as well as a higher proportion of open surgical procedures (90.8% vs. 76.9%) compared with the early surgery group. The early surgery group exhibited significantly shorter ICU length of stay, total duration of mechanical ventilation, and duration of vasoactive drug use. The incidences of ICU-acquired weakness (ICU-AW), acute kidney injury (AKI), and 28-day ICU mortality were significantly lower in the early surgery group. Surgical timing and preoperative septic shock were significantly associated with mortality. After adjustment for preoperative septic shock, early surgery remained an independent protective factor for 28-day mortality.

Conclusions: In patients with sepsis-associated intra-abdominal infection, early surgical intervention (D-to-K time ≤12 hours) is associated with improved ICU outcomes, including shorter organ support duration, lower complication rates, and reduced 28-day mortality.

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早期手术清创对ICU脓毒症相关腹腔感染患者预后的影响：回顾性分析。

目的：探讨早期手术清创（从诊断到开刀时间（D-to-K时间）≤12小时）对脓毒症相关腹腔感染患者重症监护病房（ICU）预后的影响。方法：这项单中心回顾性队列研究连续纳入了2021年1月1日至2025年1月31日期间入住ICU并接受手术清创的脓毒症相关腹腔感染患者。将患者分为早期手术组（D-to-K时间≤12小时，n = 65）和延迟手术组（D-to-K时间≤12小时，n = 87）。比较两组患者的基线特征、ICU住院时间、器官支持时间、并发症发生率、死亡率等临床结局。采用多因素logistic回归分析评估早期手术对28天死亡率的独立影响。结果：与早期手术组相比，延迟手术组术前脓毒性休克（66.7% vs. 33.8%）和弥漫性腹膜炎（50.6% vs. 32.3%）患病率更高，开放手术比例（90.8% vs. 76.9%）更高。早期手术组ICU住院时间、机械通气总时间、血管活性药物使用时间均明显缩短。早期手术组的ICU获得性虚弱（ICU- aw）、急性肾损伤（AKI）和28天ICU死亡率均明显降低。手术时机和术前感染性休克与死亡率显著相关。在调整术前感染性休克后，早期手术仍然是28天死亡率的独立保护因素。结论：在脓毒症相关腹腔感染患者中，早期手术干预（D-to-K时间≤12小时）可改善ICU预后，包括缩短器官支持时间，降低并发症发生率，降低28天死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.