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Arch Surg. 2002 Dec;137(12):1341-6; discussion 1347.

Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients.

Author information

1
Department of Anesthesiology and Surgical Intensive Care Unit, University Hospital Bichat-Claude Bernard, Paris, France. herve.dupont@bch.ap-hop-paris.fr

Abstract

BACKGROUND:

Candida peritonitis (CP) is generally considered to be a severe disease, but its impact on outcome in critically ill patients remains unknown.

HYPOTHESIS:

The predictive factors of mortality due to CP can be determined by study of a population of patients with CP.

DESIGN:

A retrospective review of a prospective surgical intensive care unit (ICU) database of patients (January 1, 1994, through December 31, 2000).

SETTING:

University hospital in Paris, France.

PATIENTS:

Eighty-three patients with generalized CP.

MAIN OUTCOME MEASURES:

Demographic and microbiologic data and outcome were collected, and nonsurvivors were compared with survivors.

RESULTS:

Overall ICU mortality due to CP was 43 (52%) of 83 patients. In a stepwise multivariate logistic regression, the following 4 variables were independently associated with mortality: APACHE II (Acute Physiology and Chronic Health Evaluation II) score on admission of at least 17 (odds ratio [OR], 28.4; 95% confidence interval [CI], 5.7-142.5; P<.001), respiratory failure on admission (OR, 10.6; 95% CI, 2.2-51.2; P =.003), upper gastrointestinal tract site of peritonitis (OR, 7.7; 95% CI, 1.7-34.7; P =.007), and results of direct examination of peritoneal fluid that were positive for Candida (OR, 4.7; 95% CI, 1.2-19.7; P =.002).

CONCLUSIONS:

These results confirm the severity of CP in ICU patients and emphasize the prognostic value of direct examination of peritoneal fluid for Candida in this context.

PMID:
12470095
[Indexed for MEDLINE]

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