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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

World Journal of Emergency Surgery 1/2012

Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

World Journal of Emergency Surgery > Ausgabe 1/2012
Massimo Sartelli, Fausto Catena, Luca Ansaloni, Ari Leppaniemi, Korhan Taviloglu, Harry van Goor, Pierluigi Viale, Daniel Vasco Lazzareschi, Federico Coccolini, Davide Corbella, Carlo de Werra, Daniele Marrelli, Sergio Colizza, Rodolfo Scibè, Halil Alis, Nurkan Torer, Salvador Navarro, Boris Sakakushev, Damien Massalou, Goran Augustin, Marco Catani, Saila Kauhanen, Pieter Pletinckx, Jakub Kenig, Salomone Di Saverio, Elio Jovine, Gianluca Guercioni, Matej Skrovina, Rafael Diaz-Nieto, Alessandro Ferrero, Stefano Rausei, Samipetteri Laine, Piotr Major, Eliane Angst, Olivier Pittet, Ihor Herych, Ferdinando Agresta, Nereo Vettoretto, Elia Poiasina, Jaan Tepp, Gunter Weiss, Giorgio Vasquez, Nikola Vladov, Cristian Tranà, Samir Delibegovic, Adam Dziki, Giorgio Giraudo, Jorge Pereira, Helen Tzerbinis, David van Dellen, Martin Hutan, Andras Vereczkei, Avdyl Krasniqi, Charalampos Seretis, Cristian Mesina, Miran Rems, Fabio Cesare Campanile, Pietro Coletta, Mirjami Uotila-Nieminen, Mario Dente, Konstantinos Bouliaris, Konstantinos Lasithiotakis, Vladimir Khokha, Dragoljub Zivanovic, Dmitry Smirnov, Athanasios Marinis, Ionut Negoi, Ludwig Ney, Roberto Bini, Miguel Leon, Sergio Aloia, Cyrille Huchon, Radu Moldovanu, Renato Bessa de Melo, Dimitrios Giakoustidis, Orestis Ioannidis, Michele Cucchi, Tadeja Pintar, Zoran Krivokapic, Jelena Petrovic
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Electronic supplementary material

The online version of this article (doi:10.​1186/​1749-7922-7-36) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MS designed the study and wrote the manuscript. FC, LA, AL, KT, HVG, DVL, PV and CDW participated in study design. DVL revised the manuscript. FCo and DC performed statistical analysis. All authors read and approved the final manuscript.


The CIAO Study (“C omplicated Intra-A bdominal infection O bservational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012).
Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.
2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified.
The overall mortality rate was 7.5% (163/2.152).
According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission.
Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.
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