The impact of timing of antibiotics on in-hospital outcomes after major emergency abdominal surgery

Harmankaya, Mücahit; Oreskov, Jakob Ohm; Burcharth, Jakob; Gögenur, Ismail

doi:10.1007/s00068-018-1026-4

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…A detailed description of the data collection can be found elsewhere. 11 Brie y, data extraction was obtained from electronic medical journals covering the time from admission to 30 days after surgery. We extracted pre-, per-and postoperative variables including age, weight, height, tobacco use, alcohol consumption, comorbidities, malignancy status, prescription medicine, oncological treatment within eight weeks prior to surgery, information on the surgical procedure, postoperative complications, and 30-day mortality.…”

Section: Methodsmentioning

confidence: 99%

Associations between malignancy and cardiovascular complications following emergency laparotomy – A retrospective cohort study

et al. 2021

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BackgroundSeveral studies have shown a possible causal relationship between the occurrence of systemic in ammation in patients with malignant disease and increased risk of cardiovascular events. Our objective was to estimate the association between malignant disease and postoperative cardiovascular complications. Secondarily, we aimed to identify risk factors for postoperative cardiovascular complications. MethodsWe conducted a retrospective cohort study of all patients ≥ 18 years undergoing emergency laparotomy

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Section: Methodsmentioning

confidence: 99%

Associations between malignancy and cardiovascular complications following emergency laparotomy – A retrospective cohort study

et al. 2021

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“…Delayed antimicrobial administration in patients with sepsis and septic shock is associated with detrimental outcomes. [80][81][82][83][84][85][86] In 2006, Kumar et al performed a retrospective study of 2,154 patients with sepsis-associated hypotension. They showed that the administration of effective antimicrobial therapy within the first hour of hypotension was associated with the highest survival benefit in septic shock patients.…”

Section: Early Administration Of Broad-spectrum Antibiotics Ideally In the First Hour Of Diagnosismentioning

confidence: 99%

“…In fact, a linear association between delays and mortality has been documented. 8,[86][87][88] Other important secondary outcomes, such as increased hospital and ICU length of stay, 85,89 worsening organ failure (acute respiratory distress syndrome, acute kidney injury), have been demonstrated in observational studies. [90][91][92][93] The doorto-needle time for antibiotic administration reflects global concerns about setting up a time-to-intervention period after the onset of symptoms.…”

Section: Early Administration Of Broad-spectrum Antibiotics Ideally In the First Hour Of Diagnosismentioning

confidence: 99%

Evidence for the Application of Sepsis Bundles in 2021

Plata-Menchaca

Ruiz‐Rodríguez

Ferrer

2021

Semin Respir Crit Care Med

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Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and quality-of-care improvements in acute emergency care. Thus, the initial interventions in sepsis are a cornerstone for prognosis in most patients. Even though the evidence supporting the hour-1 bundle is perfectible, real-life application of thoughtful and organized sepsis care has improved survival and quality of care in settings promoting compliance to evidence-based treatments. Current evidence for implementing the Surviving Sepsis Campaign bundles for early sepsis management is moving forward to better approaches as more substantial evidence evolves.

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“…[42][43][44] 42 A retrospective observational study of major emergency abdominal operations, including gastroduodenal operation, small bowel resection, colon resection, and exploratory laparotomy, found that antibiotics administered more than 12 hours after triage, compared with 6 or 12 hours, were associated with a greater odds of complications, reoperation, 30-day mortality, and prolonged LOS (all, p < 0.05). 43 Recent joint guidelines by the American Society of Health-System Pharmacists, Infectious Diseases Society of America, Surgical Infection Society, and Society for Healthcare Epidemiology of America provide recommendations for antibiotic regimens. The World Society of Emergency Surgery also published procedure-specific guidelines for many emergency abdominal procedures.…”

Section: Evidencementioning

confidence: 99%

Technical Evidence Review for Emergency Major Abdominal Operation Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

Grant

Hornor

et al. 2020

Journal of the American College of Surgeons

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Enhanced recovery pathways (ERPs), initially developed more than 2 decades ago for colorectal operations, have been shown to improve patient outcomes for many elective procedures. 1-4 They apply standardized, evidencebased, and multidisciplinary approaches to reduce surgical stress and modify physiologic responses. 5-9 As these pathways evolve, it is evident that the key principles, including multimodal analgesia, early mobilization, patient and family engagement, and best practices for preventable harms, can benefit surgical patients broadly, including those undergoing emergency operations. Emergency general surgery (EGS) represents a growing public health burden in the US, with more than 3 million patients admitted annually for these conditions and nearly 30% requiring operation. 10 EGS patients are complex; 35% are older than 70 years and 50% have at least 1 medical comorbidity and are at higher risk for morbidity (15%) and mortality (1.2%). 10,11 Rates are even higher for complex emergency procedures, including 46.9% morbidity for bowel resections and 23.8% mortality for laparotomies. 11 Quality improvement work in EGS is challenging, limited by the urgent nature and heterogeneity in disease and patient characteristics. However, given that the success of ERPs lies in reducing perioperative stress through transdisciplinary teamwork and standardization, the benefits of ERPs might be even more pronounced in this high-risk population. The Safety Program for Improving Surgical Care and Recovery (ISCR) is a national ERP initiative implemented in 2017 through a collaboration among AHRQ (funder), American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The ISCR program has been implemented across colorectal, orthopaedic, and gynecologic surgery services. Building on the lessons learned from earlier cohorts, the final cohort of the program will expand into EGS and include appendectomy; cholecystectomy; and emergency, nontrauma, and nonvascular major abdominal operations. The objective of this study was to evaluate the evidence for ERPs for emergency major abdominal operations and to provide a framework for developing and implementing ERPs in this patient population. METHODS Seven common EGS procedures, including appendectomy, cholecystectomy, perforated peptic ulcer repair, colectomy, CME questions for this article available at http://jacscme.facs.org

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The impact of timing of antibiotics on in-hospital outcomes after major emergency abdominal surgery

Cited by 10 publications

References 20 publications

Associations between malignancy and cardiovascular complications following emergency laparotomy – A retrospective cohort study

Associations between malignancy and cardiovascular complications following emergency laparotomy – A retrospective cohort study

Evidence for the Application of Sepsis Bundles in 2021

Technical Evidence Review for Emergency Major Abdominal Operation Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

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