title: Age and Its Impact on Outcomes with Intra-Abdominal Infection.
abstract: BACKGROUND
  Age has been shown to play a significant role in the etiology of complicated intra-abdominal infections (cIAIs), but the correlation between age and outcomes after therapy was not investigated in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial.
  
  
  METHODS
  Data were obtained by post hoc analysis of the STOP-IT trial database. Patients were stratified by age <65 or ≥65 years. Primary outcomes were surgical site infection (SSI), recurrent IAI (recIAI), and death. Multivariable analysis was performed to identify independent predictors of outcomes.
  
  
  RESULTS
  There were 398 subjects <65 and 120 ≥ 65 years. Overall baseline characteristics of the two groups were similar. The site of infection was similar between groups except: Colon or rectum (48.3% vs. 29.9%, p = 0.0002) and biliary tree (16.7% vs. 9.1%, p = 0.02), which were more common in the older group, whereas small intestine (6.7% vs. 16.3%, p = 0.008) and appendix (4.2% vs.17.1%, p = 0.0004) were more common in the younger group. Among the primary outcomes, only death was significantly different between the age groups and was more prevalent in the ≥65 years group (4 [3.3%] vs. 1 [0.3%], p = 0.01). Surgical site infection (9.2% vs. 7.3%, p = 0.50), recIAI (15.8% vs. 14.4%, p = 0.69), and a composite outcome (26.7% vs. 20.4%, p = 0.14) were statistically similar between the age groups, and this remained true when controlling for other co-variables. Multivariable analyses did not reveal age as an independent predictor of the composite or individual outcomes.
  
  
  CONCLUSIONS
  Patients with a more advanced age demonstrated variable sources of infection relative to the younger cohort, yet received similar treatments. Patient age was not an independent predictor of the undesired cIAI outcomes. These findings suggest that advanced age itself does not play a significant role in predicting these adverse outcomes for cIAIs and does not necessitate an altered treatment tactic.
authors.affiliation: 1 Baylor University Medical Center , Dallas, Texas.|2 JPS Health Network , Fort Worth, Texas.
authors.forename: Drew
authors.initials: D
authors.lastname: Farmer
authors.affiliation: 2 JPS Health Network , Fort Worth, Texas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Tessier
authors.affiliation: 2 JPS Health Network , Fort Worth, Texas.
authors.forename: James M
authors.initials: JM
authors.lastname: Sanders
authors.affiliation: 3 Departments of Surgery and Public Health Sciences, University of Virginia; Charlottesville, Virginia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Sawyer
authors.affiliation: 4 Department of Surgery, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Ori D
authors.initials: OD
authors.lastname: Rotstein
authors.affiliation: 5 Department of Surgery, University of Washington; Seattle, Washington.
authors.forename: E P
authors.initials: EP
authors.lastname: Dellinger
authors.affiliation: 6 Departments of Surgery, Anesthesiology, Critical Care Medicine, and Nursing, The Johns Hopkins University Schools of Medicine and Nursing , Baltimore, Maryland.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Lipsett
authors.affiliation: 5 Department of Surgery, University of Washington; Seattle, Washington.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cuschieri
authors.affiliation: 7 Department of Surgery, Wake Forest-Baptist Health , Winston-Salem, North Carolina.
authors.forename: Preston
authors.initials: P
authors.lastname: Miller
authors.affiliation: 8 Department of Surgery, Beth Israel Deaconess-Harvard Medical School , Boston, Massachusetts.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Cook
authors.affiliation: 9 Department of Surgery, University of Virginia , Charlottesville, Virginia.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Guidry
authors.affiliation: 10 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Reza
authors.initials: R
authors.lastname: Askari
authors.affiliation: 2 JPS Health Network , Fort Worth, Texas.
authors.forename: Billy J
authors.initials: BJ
authors.lastname: Moore
authors.affiliation: 2 JPS Health Network , Fort Worth, Texas.
authors.forename: Therese M
authors.initials: TM
authors.lastname: Duane
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: abdominal infection; antibiotic prophylaxis; antibiotic therapy; clinical trial; sepsis