Introduction
Methods
Clinical data
Outcomes
Statistical analysis
Results
Study population
Missing data | AIT-free patients n = 275 | Patients receiving AIT during their ICU stay n = 585 | p value | |
---|---|---|---|---|
Male, n (%) | 1/4 | 166 (61) | 386 (66) | NS |
Age, years, median [IQR] | 3/4 | 55 [40–71] | 59 [48–72] | < 0.01 |
Underlying diseases | ||||
Diabetes, n (%) | 0 | 45 (16) | 91 (16) | NS |
Cardiovascular disease, n (%) | 0 | 157 (57) | 342 (58) | NS |
Respiratory disease, n (%) | 0 | 44 (16) | 100 (17) | NS |
Renal disease, n (%) | 0 | 24 (9) | 31 (5) | NS |
Liver disease, n (%) | 0/1 | 30 (11) | 63 (11) | NS |
Smoking, n (%) | 0 | 137 (50) | 251 (43) | NS |
Alcoholism, n (%) | 0/1 | 128 (47) | 247 (42) | NS |
Attributable cause of pancreatitis | ||||
Alcoholism, n (%) | 0 | 80 (29) | 146 (25) | NS |
Gallstones, n (%) | 0 | 97 (35) | 247 (42) | NS |
Post-ERCP, n (%) | 0 | 9 (3) | 47 (8) | < 0.01 |
Hypertriglyceridaemia, n (%) | 0 | 26 (9) | 31 (5) | < 0.05 |
Cancer, n (%) | 0 | 8 (3) | 6 (1) | NS |
Toxic, n (%) | 0 | 4 (1) | 17 (3) | NS |
Undetermined, n (%) | 0 | 51 (19) | 96 (16) | NS |
Clinical presentation on admission | ||||
Pain onset/ICU admission interval, days, median [IQR] | 0 | 2 [1–3] | 3 [1–8] | < 0.001 |
Oliguria/anuria, n (%) | 0 | 120 (44) | 253 (43) | NS |
BISAP score, median [IQR] | 12/22 | 1 [0–1] | 1 [1–2] | < 0.001 |
Balthazar score E, n (%) | 0 | 137 (50) | 356 (61) | < 0.01 |
Severity criteria on admission | ||||
SOFA score, median [IQR] | 9/14 | 3 [1–5] | 5 [3–7] | < 0.001 |
Respiratory failure*, n (%) | 0 | 39 (14) | 207 (35) | < 0.001 |
Cardiovascular failure*, n (%) | 0 | 37 (13) | 202 (35) | < 0.001 |
Renal failure*, n (%) | 0 | 43 (16) | 100 (17) | NS |
Septic shock, n (%) | 0 | 3 (1) | 114 (19) | < 0.001 |
Acute respiratory distress syndrome, n (%) | 0 | 9 (3) | 53 (9) | < 0.01 |
Therapeutic management on admission | ||||
Vasoactive support, n (%) | 0/1 | 38 (14) | 207 (35) | < 0.001 |
Mechanical ventilation, n (%) | 1/5 | 38 (14) | 187 (32) | < 0.001 |
Fluid loading, n (%) | 2/12 | 178 (65) | 447 (78) | < 0.001 |
Renal replacement therapy, n (%) | 1/10 | 16 (6) | 62 (11) | < 0.05 |
Main treatments between day > 0 and day 30 | ||||
Need for red blood cell transfusion, n (%) | 0 | 31 (11) | 195 (33) | < 0.001 |
Number of days of mechanical ventilation | 1/2 | 0 [0–0] | 4 [0–16] | < 0.001 |
Vasoactive support, n (%) | 0/1 | 59 (21) | 335 (57) | < 0.001 |
Renal replacement therapy, n (%) | 1/1 | 42 (15) | 178 (30) | < 0.001 |
Duration of RRT, days, median [IQR] | 14/0 | 2 [2–4] | 7 [2–15] | < 0.001 |
Main complications between day > 0 and day 30 | ||||
Acute respiratory distress syndrome, n (%) | 0/2 | 40 (15) | 201 (34) | < 0.001 |
Septic shock, n (%) | 24/47 | 4 (2) | 210 (39) | < 0.001 |
Pancreatic necrosis, n (%) | 12/18 | 164 (62) | 393 (69) | < 0.05 |
Infected necrosis, n (%) | 15/29 | 5 (2) | 200 (36) | < 0.001 |
Gastro-intestinal perforation, n (%) | 12/32 | 4 (1) | 50 (9) | < 0.001 |
Vascular thrombosis, n (%) | 12/26 | 22 (8) | 86 (15) | < 0.01 |
Acute mesenteric ischaemia, n (%) | 12/28 | 25 (10) | 63 (11) | NS |
Intra-abdominal collection, n (%) | 10/22 | 37 (14) | 242 (43) | < 0.001 |
Abdominal compartment syndrome, n (%) | 12/26 | 17 (6) | 66 (12) | < 0.05 |
Haemorrhage, n (%) | 11/26 | 19 (7) | 81 (14) | < 0.01 |
Peritonitis, n (%) | 12/30 | 3 (1) | 85 (15) | < 0.001 |
Cholangitis, n (%) | 15/25 | 2 (1) | 57 (10) | < 0.001 |
Digestive fistula, n (%) | 12/28 | 1 (1) | 30 (5) | < 0.001 |
Clinical management between day > 0 and day 30 | ||||
Endoscopic necrosectomy, n (%) | 2/6 | 24 (9) | 152 (26) | < 0.001 |
Surgical necrosectomy, n (%) | 0/6 | 32 (12) | 219 (38) | < 0.001 |
Radiological drainage, n (%) | 0/6 | 8 (3) | 120 (21) | < 0.001 |
Duration of ICU stay, days, median [IQR] | 0 | 3 [1–6] | 12 [4–27] | < 0.001 |
ICU readmission, n (%) | 0/1 | 6 (2) | 50 (9) | < 0.001 |
Hospital mortality rate, n (%) | 0 | 54 (20) | 143 (24) | NS |
Time to death, days, median [IQR] | 0 | 1.5 [1–2] | 12 [2–34] | < 0.001 |
Anti-infective therapy on ICU admission
Missing data | AIT-free patients on day 0 n = 501 | Patients receiving AIT on day 0 n = 359 | p value | |
---|---|---|---|---|
Male, n (%) | 0/5 | 313 (62) | 239 (68) | NS |
Age, years, median [IQR] | 3/4 | 56 [43–71] | 60 [49–73] | < 0.01 |
Clinical presentation on admission | ||||
Pain onset/ICU admission interval, days, median [IQR] | 0 | 2 [1–4] | 4 [1–11] | < 0.001 |
Oliguria/anuria, n (%) | 0 | 219 (44) | 154 (43) | NS |
BISAP score, median [IQR] | 16/18 | 1 [0–1] | 2 [1–2] | < 0.001 |
Balthazar score E, n (%) | 0 | 293 (58) | 200 (56) | NS |
Severity criteria on admission | ||||
SOFA score, median [IQR] | 10/12 | 4 [2–6] | 5 [3–7] | < 0.001 |
Respiratory failure*, n (%) | 0 | 109 (22) | 137 (38) | < 0.001 |
Cardiovascular failure*, n (%) | 0 | 77 (15) | 162 (45) | < 0.001 |
Renal failure*, n (%) | 0 | 90 (18) | 53 (15) | NS |
Septic shock, n (%) | 0 | 7 (1) | 110 (31) | < 0.001 |
Acute respiratory distress syndrome, n (%) | 0 | 25 (5) | 37 (10) | < 0.01 |
Therapeutic management on admission | ||||
Vasoactive support, n (%) | 0/1 | 80 (16) | 165 (46) | < 0.001 |
Mechanical ventilation, n (%) | 1/5 | 95 (19) | 130 (37) | < 0.001 |
Fluid loading, n (%) | 2/12 | 348 (70) | 277 (80) | < 0.01 |
Renal replacement therapy, n (%) | 1/10 | 36 (7) | 42 (12) | < 0.05 |
Anti-infective therapy, n (%) | 0 | – | 359 (100) | < 0.001 |
Main treatments between day > 0 and day 30 | ||||
Need for red blood cell transfusion, n (%) | 0 | 110 (22) | 116 (32) | < 0.001 |
Number of days of mechanical ventilation | 2/8 | 0 [0–9] | 2 [0–10] | < 0.001 |
Vasoactive support, n (%) | 0/1 | 186 (37) | 208 (58) | < 0.001 |
Renal replacement therapy, n (%) | 2/0 | 127 (25) | 93 (26) | NS |
Duration of RRT, days, median [IQR] | 6/9 | 5 [2–14] | 5 [2–15] | NS |
Main complications between day > 0 and day 30 | ||||
Acute respiratory distress syndrome, n (%) | 0/2 | 142 (28) | 99 (28) | NS |
Septic shock, n (%) | 39/32 | 90 (19) | 124 (38) | 0.001 |
Pancreatic necrosis, n (%) | 13/17 | 339 (69) | 218 (64) | NS |
Infected necrosis, n (%) | 20/24 | 88 (18) | 117 (35) | < 0.001 |
Gastro-intestinal perforation, n (%) | 20/24 | 27 (6) | 27 (8) | NS |
Vascular thrombosis, n (%) | 16/22 | 55 (11) | 53 (16) | NS |
Acute mesenteric ischaemia, n (%) | 18/22 | 52 (11) | 36 (11) | NS |
Intra-abdominal collection, n (%) | 14/18 | 127 (26) | 152 (45) | < 0.001 |
Abdominal compartment syndrome, n (%) | 16/22 | 52 (11) | 31 (9) | NS |
Haemorrhage, n (%) | 16/21 | 53 (11) | 47 (14) | NS |
Peritonitis, n (%) | 19/23 | 29 (6) | 59 (18) | < 0.001 |
Cholangitis, n (%) | 21/19 | 18 (4) | 41 (12) | < 0.001 |
Digestive fistula, n (%) | 19/21 | 11 (2) | 20 (6) | < 0.01 |
Clinical management between day > 0 and day 30 | ||||
Endoscopic necrosectomy, n (%) | 3/5 | 89 (18) | 87 (25) | < 0.05 |
Surgical necrosectomy, n (%) | 1/5 | 119 (24) | 132 (37) | < 0.001 |
Radiological drainage, n (%) | 1/5 | 56 (11) | 72 (20) | < 0.001 |
Duration of ICU stay, days, median [IQR] | 0 | 6 [2–17] | 8 [3–21] | < 0.05 |
ICU readmission n (%) | 0/1 | 30 (6) | 26 (7) | NS |
Hospital mortality rate, n (%) | 0 | 104 (21) | 93 (26) | NS |
Time to death, days, median [IQR] | 0 | 3 [1–18] | 7 [1–31] | NS |
Missing data | Carbapenems n = 81 | Other AIT n = 278 | p value | |
---|---|---|---|---|
Severity criteria at day 0 | ||||
SOFA score, median [IQR] | 4/9 | 5 [3–7] | 5 [3–7] | NS |
Respiratory failure*, n (%) | 0 | 32 (40) | 103 (37) | NS |
Cardiovascular failure*, n (%) | 0 | 39 (48) | 123 (44) | NS |
Renal failure*, n (%) | 0 | 14 (17) | 53 (19) | NS |
Septic shock, n (%) | 0 | 29 (36) | 81 (29) | NS |
Acute respiratory distress syndrome, n (%) | 0 | 11 (14) | 26 (9) | NS |
Main reasons for anti-infective therapy at day 0 | ||||
Empirical therapy, n (%) | 0 | 67 (83) | 232 (83) | NS |
Intra-abdominal infection, n (%) | 1/5 | 55 (69) | 155 (57) | NS |
Pneumonia, n (%) | 2/6 | 7 (9) | 39 (14) | NS |
Bacteraemia, n (%) | 2/3 | 6 (8) | 39 (14) | NS |
Catheter-related infection, n (%) | 2/3 | 2 (3) | 7 (3) | NS |
Urinary tract infection, n (%) | 2/4 | – | 9 (3) | NS |
Skin and soft tissue infection, n (%) | 2/3 | – | 2 (1) | NS |
Most frequently prescribed anti-infective agents at day 0 | ||||
Beta-lactams, n (%) | 0 | 81 (100) | 191 (69) | < 0.001 |
Aminoglycosides, n (%) | 0 | 41 (51) | 79 (28) | < 0.001 |
Anti-Gram-positive agents, n (%) | 0 | 20 (30) | 30 (11) | < 0.01 |
Antifungal agents, n (%) | 0 | 20 (25) | 33 (12) | < 0.01 |
Azoles, n (%) | 0 | 18 (22) | 28 (10) | < 0.01 |
Echinocandins, n (%) | 0 | 1 (1) | 4 (1) | NS |
Duration of AIT, days, median [IQR] | 3/8 | 7 [3–15] | 4 [1–10] | < 0.01 |
ICU length of stay, days, median [IQR] | 0 | 14 [4–27] | 8 [3–19] | < 0.05 |
ICU readmission, n (%) | 0/1 | 5 (6) | 22 (8) | NS |
Hospital mortality, n (%) | 0 | 22 (27) | 71 (26) | NS |
Time to death, days, median [IQR] | 0 | 31 [7–43] | 3 [1–19] | < 0.01 |
Anti-infective therapy between day > 0 and day 30
Missing data | Patients receiving AIT from day 0 n = 340 | Patients receiving AIT between day > 0 and day 30 n = 226 | p value | |
---|---|---|---|---|
Male, n (%) | 0/4 | 227 (68) | 147 (65) | NS |
Age, years, median [IQR] | 1/1 | 59 [49–73] | 58 [47–70] | NS |
Clinical presentation on day 0 | ||||
Delay pain/ICU admission, days, median [IQR] | 0 | 4 [1–11] | 2 [1–5] | < 0.001 |
Oliguria/anuria, n (%) | 0 | 151 (44) | 99 (44) | NS |
BISAP score, median [IQR] | 4/14 | 2 [1–2] | 1 [0–2] | < 0.001 |
Balthazar score grade E, n (%) | 0 | 196 (58) | 155 (69) | < 0.05 |
Severity criteria on day 0 | ||||
SOFA score, median [IQR] | 1/11 | 5 [3–7] | 4 [3–6] | < 0.05 |
Respiratory failure*, n (%) | 0 | 129 (38) | 68 (30) | NS |
Cardiovascular failure*, n (%) | 0 | 157 (46) | 40 (18) | < 0.001 |
Renal failure*, n (%) | 0 | 65 (19) | 51 (23) | NS |
Septic shock, n (%) | 0 | 106 (31) | 4 (2) | < 0.001 |
Acute respiratory distress syndrome, n (%) | 0 | 36 (11) | 16 (7) | NS |
Therapeutic management on day 0 | ||||
Vasoactive support, n (%) | 0/1 | 160 (47) | 42 (19) | < 0.001 |
Mechanical ventilation, n (%) | 0/4 | 126 (38) | 57 (25) | < 0.01 |
Fluid loading, n (%) | 1/9 | 270 (82) | 169 (75) | NS |
Renal replacement therapy, n (%) | 1/7 | 40 (12) | 20 (9) | NS |
Main treatments between day > 0 and day 30 | ||||
Need for red blood cells transfusion, n (%) | 0 | 113 (33) | 78 (35) | NS |
Duration of mechanical ventilation, days, median [IQR] | 2/8 | 3 [0–11] | 9 [0–21] | < 0.001 |
Vasoactive support, n (%) | 0/1 | 205 (60) | 126 (56) | NS |
Renal replacement therapy, n (%) | 1/0 | 91 (27) | 85 (38) | < 0.01 |
Duration of RRT, days, median [IQR] | 5/6 | 5 [2–15] | 10 [3–16] | NS |
Duration of AIT, days, median [IQR] | 13/11 | 5 [2–12] | 7 [3–14] | < 0.01 |
Main complications between day > 0 and day 30 | ||||
Acute respiratory distress syndrome, n (%) | 0/2 | 100 (30) | 101 (45) | < 0.001 |
Septic shock, n (%) | 16/30 | 123 (40) | 85 (40) | NS |
Pancreatic necrosis, n (%) | 2/16 | 211 (65) | 174 (78) | < 0.01 |
Infected necrosis, n (%) | 6/22 | 113 (36) | 83 (38) | NS |
Gastro-intestinal perforation, n (%) | 9/21 | 28 (9) | 22 (10) | NS |
Vascular thrombosis, n (%) | 5/20 | 50 (16) | 33 (15) | NS |
Acute mesenteric ischaemia, n (%) | 7/20 | 35 (11) | 27 (12) | NS |
Intra-abdominal collection, n (%) | 5/16 | 147 (45) | 89 (40) | NS |
Abdominal compartment syndrome, n (%) | 4/21 | 30 (9) | 35 (16) | < 0.05 |
Haemorrhage, n (%) | 6/20 | 46 (14) | 33 (15) | NS |
Peritonitis, n (%) | 8/22 | 58 (18) | 25 (11) | < 0.05 |
Cholangitis, n (%) | 7/18 | 41 (13) | 16 (7) | < 0.05 |
Digestive fistula, n (%) | 8/20 | 21 (7) | 9 (4) | NS |
Clinical management between day > 0 and day 30 | ||||
Endoscopic necrosectomy, n (%) | 2/4 | 83 (25) | 64 (29) | NS |
Surgical necrosectomy, n (%) | 2/4 | 131 (39) | 86 (38) | NS |
Radiological drainage, n (%) | 2/4 | 72 (21) | 47 (21) | NS |
Duration of ICU stay, days, median [IQR] | 0 | 8 [3–22] | 17 [7–34] | < 0.001 |
ICU readmission, n (%) | 0/1 | 27 (8) | 23 (10) | NS |
Hospital mortality rate, n (%) | 0 | 91 (27) | 50 (22) | NS |
Time to death, days, median [IQR] | 0 | 8 [1–31] | 17 [5–38] | < 0.05 |
Missing data | Carbapenems n = 202 | Other AIT n = 364 | p value | |
---|---|---|---|---|
Severity criteria on admission | ||||
SOFA score, median [IQR] | 4/8 | 5 [3–7] | 5 [3–6] | NS |
Respiratory failure*, n (%) | 0 | 74 (37) | 123 (34) | NS |
Cardiovascular failure*, n (%) | 0 | 79 (39) | 118 (32) | NS |
Renal failure*, n (%) | 0 | 39 (19) | 77 (21) | NS |
Septic shock, n (%) | 0 | 45 (22) | 65 (18) | NS |
Acute respiratory distress syndrome, n (%) | 0 | 27 (13) | 25 (7) | < 0.05 |
Main treatments between day > 0 and day 30 | ||||
Need for red blood cell transfusion, n (%) | 0 | 87 (43) | 104 (29) | < 0.001 |
Number of days of mechanical ventilation | 5/5 | 12 [2–26] | 2 [0–10] | < 0.001 |
Vasoactive support, n (%) | 0/1 | 147 (73) | 184 (51) | < 0.001 |
Renal replacement therapy, n (%) | 0/1 | 82 (41) | 94 (26) | < 0.001 |
Duration of RRT, days, median [IQR] | 6/5 | 10 [3–22] | 5 [2–13] | < 0.01 |
Main complications between day > 0 and day 30 | ||||
Acute respiratory distress syndrome, n (%) | 1/1 | 101 (50) | 100 (28) | < 0.001 |
Septic shock, n (%) | 15/31 | 102 (55) | 106 (32) | < 0.001 |
Pancreatic necrosis, n (%) | 4/14 | 156 (79) | 229 (65) | < 0.001 |
Infected necrosis, n (%) | 8/20 | 96 (49) | 100 (29) | < 0.001 |
Gastro-intestinal perforation, n (%) | 12/18 | 23 (12) | 27 (8) | NS |
Vascular thrombosis, n (%) | 9/16 | 36 (19) | 47 (14) | NS |
Acute mesenteric ischaemia, n (%) | 10/17 | 26 (14) | 36 (10) | NS |
Intra-abdominal collection, n (%) | 6/15 | 105 (54) | 131 (38) | < 0.001 |
Abdominal compartment syndrome, n (%) | 9/17 | 33 (17) | 32 (9) | < 0.01 |
Haemorrhage, n (%) | 8/18 | 44 (23) | 35 (10) | < 0.001 |
Peritonitis, n (%) | 11/19 | 36 (19) | 47 (14) | NS |
Cholangitis, n (%) | 8/17 | 18 (9) | 39 (11) | NS |
Digestive fistula, n (%) | 10/18 | 11 (6) | 19 (5) | NS |
Clinical management between day > 0 and day 30 | ||||
Endoscopic necrosectomy, n (%) | 1/5 | 76 (38) | 71 (20) | < 0.001 |
Surgical necrosectomy, n (%) | 1/5 | 94 (47) | 123 (34) | < 0.01 |
Radiological drainage, n (%) | 1/5 | 63 (31) | 56 (16) | < 0.001 |
Main reasons for anti-infective therapy between day > 0 and day 30 | ||||
Intra-abdominal infection, n (%) | 11/13 | 153 (80) | 194 (55) | < 0.001 |
Pneumonia, n (%) | 11/14 | 79 (41) | 89 (25) | < 0.001 |
Bacteraemia, n (%) | 10/15 | 60 (31) | 76 (22) | < 0.05 |
Anti-infective therapy administered between day > 0 and day 30 | ||||
Duration of AIT, days, median [IQR] | 8/16 | 10 [3–17] | 5 [2–10] | < 0.001 |
Aminoglycosides, n (%) | 4/19 | 129 (65) | 118 (34) | < 0.001 |
Anti-Gram-positive agents, n (%) | 10/23 | 101 (53) | 60 (18) | < 0.001 |
Antifungal agents, n (%) | 0/2 | 54 (27) | 56 (15) | < 0.01 |
Azoles, n (%) | 6/2 | 32 (16) | 35 (10) | < 0.05 |
Echinocandins, n (%) | 6/2 | 24 (12) | 20 (6) | < 0.01 |
Duration of ICU stay, days, median [IQR] | 0 | 22 [9–39] | 8 [3–19] | < 0.001 |
ICU readmission n (%) | 1/0 | 21 (10) | 29 (8) | NS |
Hospital mortality rate, n (%) | 0 | 64 (32) | 77 (21) | < 0.01 |
Time to death, days, median [IQR] | 0 | 29 [11–45] | 4 [1–18] | < 0.001 |