Clinical Practice Guidelines in Complicated Intra-Abdominal Infection 2018: An Indonesian Perspective

Lalisang, Toar J.M.; Usman, Nurhayat; Hendrawidjaya, Iswanto; Handaya, Adeodatus Yuda; Nasution, Safruddin; Saunar, Rofi; Loho, Tonny; Karuniawati, Anis; Moenadjat, Yefta; Widyahening, Indah Suci

doi:10.1089/sur.2018.120

Cited by 13 publications

(11 citation statements)

References 24 publications

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“…Among the 14 documents included were 12 guidelines and 2 consensuses (Table 1 ). [ 12 – 26 ] The promulgation time ranged from 2002 to 2018. The content ranged from 3–76 pages, 7–690 references, and 7–55 authors participating in the editing.…”

Section: Resultsmentioning

confidence: 99%

The quality assessment of intraabdominal infection guidelines/consensuses in 2 decades - which are better and any changes?

Wang¹,

Guo²,

Xiong

et al. 2020

Medicine

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Background and aim: Intraabdominal infection (IAI) is a common and important disease worldwide. An increasing number of related guidelines/consensuses have been published in recent years, the quality evaluation for these guidelines/consensuses is necessary to identify lower-quality documents and explore the quality distribution in different time range and areas in this field. Methods: The Appraisal of Guidelines for Research & Evaluation Instrument tool was adopted to assess the quality of IAI guidelines/consensuses by 3 researchers independently. Intraclass correlation coefficients (ICCs) among the researchers were retrieved to reflect reliability. The quality differences of these guidelines/consensuses issued before and after May 2009, both international and non-international, were compared by a Mann–Whitney U test. Results: Fourteen IAI guidelines/consensuses published in English were obtained following a literature search. The ICCs among the researchers were all above 0.75, indicating satisfactory reliability. This outcome showed that the overall quality of these guidelines/consensuses was mediocre and considered acceptable in all items. A few guidelines/consensuses were better in their scientific and methodological characteristics than the others. Moreover, there were no significant differences in the scores between the guidelines/consensuses issued before and after May 2009 or between international vs regional guidelines/consensuses. Conclusions: Overall, the quality of the IAI guidelines/consensuses was generally acceptable and applicable, with a few deficiencies. Therefore, continuous improvement is essential. The guideline assessment tools should be applied in guideline/consensus development both widely and strictly to improve the methodological quality.

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Section: Resultsmentioning

confidence: 99%

The quality assessment of intraabdominal infection guidelines/consensuses in 2 decades - which are better and any changes?

Wang¹,

Guo²,

Xiong

et al. 2020

Medicine

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“…As a result, anaerobic glycolysis is enhanced and lactic acid production increases, leading to hypoxia-associated changes in renal cells that subsequently cause inflammation. As necrosis of the small intestine progresses, blood volume, cardiac output, and renal blood flow decrease leading to increased levels of renally toxic substances in the blood; in turn, this process affects renal function and leads to increased BUN levels [ 27 ]. Wei [ 28 ] et al found that the BUN levels significantly increase when necrosis of the small intestine occurs, including in patients with AMI.…”

Section: Discussionmentioning

confidence: 99%

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

et al. 2021

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Background Acute mesenteric ischemia (AMI) is a life-threatening condition. However, there is no accurate method to predict intestinal necrosis in AMI patients that may facilitate early surgical intervention. This study thus aimed to explore a simple and accurate model to predict intestinal necrosis in patients with AMI. Methods A single-center retrospective study was performed on the data of 132 AMI patients treated between October 2011 and June 2020. The patients were divided into the intestinal necrosis and non-intestinal necrosis groups. The clinical characteristics and laboratory data were analyzed by univariate analysis, and the variables with statistical significance were further analyzed by multivariate logistic regression analysis. The independent predictors of intestinal necrosis were determined and a logistic prediction model was established. Finally, the accuracy, sensitivity, and specificity of the model in predicting intestinal necrosis were evaluated. Results Univariate analysis showed that white blood cell (WBC) count, blood urea nitrogen (BUN) level, neutrophil ratio, prothrombin time (PT), and LnD-dimer were associated with intestinal necrosis. According to logistic regression multivariate analysis, WBC count, BUN level and LnD-dimer were independent predictors of intestinal necrosis. These parameters were used to establish a clinical prediction model of intestinal necrosis (CPMIN) as follows: model score = 0.349 × BUN (mmol/L) + 0.109 × WBC × 109 (109/L) + 0.394 × LnD − Dimer (ug/L) − 7.883. The area under the receiver operating characteristics (ROC) curve of the model was 0.889 (95% confidence interval: 0.833–0.944). Model scores greater than − 0.1992 predicted the onset of intestinal necrosis. The accuracy, specificity, and sensitivity of the model were 82.6%, 78.2%, and 88.3%, respectively. The proportion of intestinal necrosis in the high-risk patient group (CPMIN score ≥ − 0.1992) was much greater than that in the low-risk patient group (CPMIN score < − 0.1992; 82.7% vs. 15.0%, p < 0.001). Conclusion The CPMIN can effectively predict intestinal necrosis and guide early surgical intervention to improve patient prognosis. Patients with AMI who are classified as high-risk should be promptly treated with surgery to avoid the potential complications caused by delayed operation. Patients classified as low-risk group can receive non-surgical treatment. This model may help to lower the morbidity and mortality from AMI. However, this model’s accuracy should be validated by larger sample size studies in the future.

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“…We decided to perform OC with subcostal (Kocher) incision instead of the conventional median incision to prevent manipulation and stimulation of the fundus of the uterus that could result in preterm birth. Antibiotic therapy of 1gr meropenem thrice a day is also provided before surgery because meropenem is the gold standard drug for complicated abdominal infections and has been proven to be safe in pregnancy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Management of gallstone-induced severe acute cholecystitis and pancreatitis in the second trimester of pregnancy during covid-19 pandemic: A case report

Handaya

Fauzi

Andrew

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be life-threatening both for the mother and fetus. Surgical approach is recommended in this complicated disease to prevent morbidity and mortality. During COVID-19 pandemic, additional precautions are needed when dealing with abdominal complaints. Presentation of case We present a 37-year-old female patient, pregnant at 22 weeks gestational age, who complained of fever, diffuse abdominal pain, and shortness of breath. Laboratory examination results revealed anemia, leukocytosis and an increase in amylase level. SARS-CoV-2 antibody is non-reactive. Imaging strongly suggested cholelithiasis and cholecystitis. The patient was given antibiotics for three days but there was no significant improvement. Open cholecystectomy with subcostal (Kocher) incision was performed. Patient was released from the hospital without post-operative complications. Discussion Treatment of gallstone induced severe acute cholecystitis with acute pancreatitis during pregnancy is challenging with the surgical complications. In the second and third trimester of pregnancy, it is more difficult to perform laparoscopic cholecystectomy because of the size of uterus. Laparoscopic procedure is also not recommended in early Covid-19 pandemic period. Therefore, open cholecystectomy with Kocher incision becomes the surgery of choice to avoid preterm birth. Conclusions Based on our case, open cholecystectomy with Kocher incision is a safe and effective procedure for pregnant patients with cholelithiasis, cholecystitis, and pancreatitis.

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Clinical Practice Guidelines in Complicated Intra-Abdominal Infection 2018: An Indonesian Perspective

Cited by 13 publications

References 24 publications

The quality assessment of intraabdominal infection guidelines/consensuses in 2 decades - which are better and any changes?

The quality assessment of intraabdominal infection guidelines/consensuses in 2 decades - which are better and any changes?

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

Management of gallstone-induced severe acute cholecystitis and pancreatitis in the second trimester of pregnancy during covid-19 pandemic: A case report

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