Epidemiology and Age-Related Mortality in Critically Ill Patients With Intra-Abdominal Infection or Sepsis: An International Cohort Study
Abdominal Sepsis Study (AbSeS) group on behalf of the Trials Group of the European Society of Intensive Care Medicine
(2022) International Journal of Antimicrobial Agents, volume 60, issue 1, pp. 1 - 12
(Article)
Abstract
Objective: To describe epidemiology and age-related mortality in critically ill older adults with intra-abdominal infection. Methods: A secondary analysis was undertaken of a prospective, multi-national, observational study (Abdominal Sepsis Study, ClinicalTrials.gov #NCT03270345) including patients with intra-abdominal infection from 309 intensive care units (ICUs) in 42 countries between January and December
... read more
2016. Mortality was considered as ICU mortality, with a minimum of 28 days of observation when patients were discharged earlier. Relationships with mortality were assessed by logistic regression analysis. Results: The cohort included 2337 patients. Four age groups were defined: middle-aged patients [reference category; 40–59 years; n=659 (28.2%)], young-old patients [60–69 years; n=622 (26.6%)], middle-old patients [70–79 years; n=667 (28.5%)] and very old patients [≥80 years; n=389 (16.6%)]. Secondary peritonitis was the predominant infection (68.7%) and was equally prevalent across age groups. Mortality increased with age: 20.9% in middle-aged patients, 30.5% in young-old patients, 31.2% in middle-old patients, and 44.7% in very old patients (P<0.001). Compared with middle-aged patients, young-old age [odds ratio (OR) 1.62, 95% confidence interval (CI) 1.21–2.17], middle-old age (OR 1.80, 95% CI 1.35–2.41) and very old age (OR 3.69, 95% CI 2.66–5.12) were independently associated with mortality. Other independent risk factors for mortality included late-onset hospital-acquired intra-abdominal infection, diffuse peritonitis, sepsis/septic shock, source control failure, liver disease, congestive heart failure, diabetes and malnutrition. Conclusions: For ICU patients with intra-abdominal infection, age >60 years was associated with mortality; patients aged ≥80 years had the worst prognosis. Comorbidities and overall disease severity further compromised survival. As all of these factors are non-modifiable, it remains unclear how to improve outcomes.
show less
Download/Full Text
The full text of this publication is not available.
Keywords: ICU, Intra-abdominal infection, Mortality, Older adults, Sepsis, Microbiology (medical), Infectious Diseases, Pharmacology (medical), Journal Article
ISSN: 0924-8579
Publisher: Elsevier
Note: Funding Information: This study was registered at ClinicalTrials.gov (No. NCT03270345) prior to conducting the research. Funding: AbSeS is a Trials Group Study of the European Society of Intensive Care Medicine, and was supported by a Pfizer investigator-initiated research grant. Competing interests: Received grants related to the submitted work: S. Blot (Pfizer). Received honoraria or grants outside the submitted work: M. Antonelli (Fresenius, Pfizer, Toray); J. De Waele (Research Foundation Flanders, Pfzer, Bayer, MSD); C. Eckmann (Merck, Pfizer); J. Lipman (MSD, Pfizer); and E. Maseda (Astellas Pharma, Pfzer, MSD) All other authors report no conflicts of interest. Ethical approval: Ethical approval for participating centres was obtained at hospital, regional or national level. National coordinators, Algeria: Amin Lamrous (CHU Alger). Argentina: Cecilia Pereyra (Hospital Interzonal Agudos Prof Dr Luis Guemes, Buenos Aires), Fernando Lipovestky (Universidad Abierta Interamericana Hospital, Buenos Aires). Australia: Despoina Koulenti (UQCCR, Faculty of Medicine, The University of Queensland, Brisbane). Belgium: Jan De Waele (Ghent University Hospital, Ghent); Canada: Joao Rezende-Neto (St Michael's Hospital, Toronto). Colombia: Yenny Cardenas (Hospital Universitario Fundación Santa Fe, Bogotá). Czech Republic: Tomas Vymazal (Motol University Hospital, Prague). Denmark: Hans Fjeldsoee-Nielsen (Nykoebing Falster Hospital, Nykoebing Falster). France: Philippe Montravers (CHU Bichat Claude Bernard, Paris). Germany: Matthias Lindner (geb. Kott) (Universitätsklinikum, Schleswig-Holstein, Kiel). Greece: Arvaniti Kostoula (Papageorgiou General Hospital, Thessaloniki). India: Yash Javeri (Nayati Healthcare, Delhi). Italy: Massimo Girardis (University Hospital of Modena, Modena). Israel: Sharon Einav (Shaare Zedek Medical Centre, Jerusalem). Netherlands: Dylan de Lange (University Medical Centre, Utrecht). Peru: Luis Daniel Umezawa Makikado (Clínica Ricardo Palma, Lima). Poland: Adam Mikstacki (Regional Hospital, Poznan). Portugal: José-Artur Paiva (Centro Hospitalar UniversitárioSao João, Porto). Romania: Dana Tomescu (Fundeni Clinical Institute, Bucharest). Russian Federation: Alexey Gritsan (Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Krasnoryarsk). Serbia; Bojan Jovanovic (Clinical Centre of Serbia, Belgrade). Singapore: Kumaresh Venkatesan (Khoo Teck Puat Hospital, Singapore). Slovenia: Tomislav Mirkovic (University Medical Centre, Ljubljana). Spain: Emilio Maseda (Hospital Universitario La Paz, Madrid). Turkey: Yalim Dikmen (Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul). UK: Benedict Creagh-Brown (Royal Surrey County Hospital NHS Foundation Trust, Guildford). Investigators, Algeria: CHU (Algiers): Amin Lamrous. Argentina: Sanatorio Güemes (Buenos Aires): Monica Emmerich, Mariana Canale; Sanatorio de la Trinidad Mitre (Buenos Aires): Lorena Silvina Dietz, Santiago Ilutovich; Hospital General de Agudos "Dr. Teodoro Alvarez" (Buenos Aires): John Thomas Sanchez Miñope, Ramona Baldomera Silva; Hospital Militar Central (Buenos Aires): Martin Alexis Montenegro, Patricio Martin; Policlinico Central Union Obrera Metalurgica (Buenos Aires): Pablo Saul, Viviana Chediack; Sanatorio San José (Buenos Aires): Giselle Sutton, Rocio Couce; Hospital General de Agudos "Dr. Ignacio Pirovano" (Buenos Aires): Carina Balasini, Susana Gonzalez; Hospital Britanico (Buenos Aires): Florencia Maria Lascar, Emiliano Jorge Descotte; CMPF Churruca-Visca (Buenos Aires): Natalia Soledad Gumiela, Carina Alejandra Pino; Clinica San Camilo (Buenos Aires): Cristian Cesio, Emanuel Valgolio; Hospital Francisco Javier Muñiz (Buenos Aires): Eleonora Cunto, Cecilia Dominguez; Universidad Abierta Interamericana Hospital (Buenos Aires): Fernando Lipovestky; Hospital Alberto Balestrini (Buenos Aires): Nydia Funes Nelson, Esteban Martin Abegao; Hospital Interzonal Agudos Prof Dr Luis Güemes (Buenos Aires): Cecilia Pereyra, Norberto Christian Pozo; Hospital Español (Buenos Aires): Luciana Bianchi, Enrique Correger; Clinica Zabala (Caba): Maria Laura Pastorino, Erica Aurora Miyazaki; Hospital César Milstein (Caba): Norberto Christian Pozo, Nicolas Grubissich; Hospital Regional Victor Sanguinetti (Comodoro): Mariel Garcia, Natalia Bonetto; Hospital Municipal de Urgencias (Cordoba): Noelia Elizabeth Quevedo, Cristina Delia Gomez; Hospital Manuel B Cabrera (Coronel Pringles): Felipe Queti, Luis Gonzalez Estevarena; Hospital Español de Mendoza (Mendoza,Godoy Cruz: Ruben Fernandez, Ignacio Santolaya; H.I.G.A. Prof. Dr. Luis Güemes (Haedo): Norberto Christian Pozo; Hospital Municipa Doctor Carlos Macias (Mar de Ajo): Sergio Hugo Grangeat, Juan Doglia; Hospital Luis C. Lagomaggiore (Mendoza): Graciela Zakalik, Carlos Pellegrini; Hospital Nacional Profesor Alejandro Posadas (Moron): Maria Monserrat Lloria, Mercedes Esteban Chacon; Hospital Provincial de Neuquen (Neuquen): Mariela Fumale; Clinica Modelo S.A (Paraná): Mariela Leguizamon; Sanatorio de la Ciudad (Puerto Madryn): Irene Beatriz Hidalgo, Roberto Julian Tiranti; Sanatorio Nosti (Rafaela): Paola Capponi, Agustin Tita; Hospital Provincial del Centenario (Rosario): Luis Cardonnet, Lisandro Bettini; Sanatorio Parque (Rosario): Agñel Ramos, Luciano Lovesio; Hospital Papa Francisco (Salta): Edith Miriam Miranda, Angelica Beatriz Farfan; Hospital San Juan Bautista (San Fernando del Valle de Catamarca): Carina Tolosa, Lise Segura; Hospital Central San Isidro Dr Melchor A. Posse (San Isidro-Buenos Aires): Adelina Bellocchio, Brian Alvarez; Hospital Guillermo Rawson (San Juan): Adriana Manzur, Rodolfo Lujan; EstablecimientoAsistencial Dr Lucio Molas (Santa Rosa): Natalia Fernandez, Nahuel Scarone; Clínica de Especialidades (Villa María): Alan Zazu, Carina Groh. Australia: The Bendigo Hospital (Bendigo): Jason Fletcher, Julie Smith; Coffs Harbour Health Campus (Coffs Harbour): Raman Azad, Nitin Chavan; Concord Hospital (Concord): Helen Wong; Mark Kol; Royal Darwin Hospital (Darwin): Lewis Campbell; Royal Brisbane and Women's Hospital (Herston, Brisbane): Despoina Koulenti, Therese Starr; Sir Charles Gairdner Hospital (Nedlands): Brigit Roberts, Bradley Wibrow; Redcliffe Hospital (Redcliffe): Timothy Warhurst; St Vincent's Hospital (Toowommba): Meher Chinthamuneedi, Bernal Buitrago Ferney. Belgium: Cliniques du Sud Luxembourg (CSL)-Hôpital Saint-Joseph (Arlon):Marc Simon; Chirec Hospital (Braine-l'Alleud): Daniel De Backer; Cliniques Universitaires St Luc (Brussels): Xavier Wittebole; Brugmann University Hospital (Brussels): David De Bels, Cliniques de l'Europe - St-Michel (Brussels): Vincent Collin; University Hospital Antwerp (Edegem): Karolien Dams, Philippe Jorens; Ghent University Hospital (Ghent): Jan De Waele, Mieke Deschepper; University College Ghent (Ghent): Sonia Labeau; Jessa Ziekenhuis (Hasselt): Jasperina Dubois; University Hospitals Leuven (Leuven): Jan Gunst; CHU Ambroise Paré (Mons): Lionel Haentjens; Clinique Saint-Pierre (Ottignies): Nicolas De Schryver, Thierry Dugernier. Canada: St. Michael's Hospital (Toronto): Joao Rezende-Neto, Sandro Rizoli. Chile: Hospital Clinico Viña del Mar (Viña del Mar): Paul Santillan. China: Jiangsu Province Hospital (Nanjing): Yi Han; Yangpu Hospital of Tongji University (Shanghai): Ewelina Biskup, Changjing Qu; Urumqi General Hospital (Urumqi): Xinyu Li, Wannan Medical College First Affiliated Hospital, Yijishan Hospital (Wuhu): Tao Yu, Lu Weihua. Colombia: Clinica Universitaria Colombia (Bogota): Daniel Molano-Franco, José Rojas, Mederi Hospital (Bogota): Juan Mauricio Pardo Oviedo; Dario Pinilla; Hospital Universitario Fundación Santa Fe (Bogota): Yenny Cardenas, Edgar Celis; Clinica Santa Gracia (Popayan): Mario Arias. Croatia: Opća bolnica Dubrovnik (Dubrovnik): Anita Vukovic, Maja Vudrag; General Hospital Karlovac (Karlovac): Matija Belavic, Josip Zunic; Clinical Hospital Centre Rijeka (Rijeka): Janja Kuharic, Irena Bozanic Kricka; University Hospital Centre of Zagreb (Zagreb): Ina Filipovic-Grcic, Boris Tomasevic; University Hospital Centre Sestre Milosrdnice (Zagreb): Melanija Obraz, Bruna Bodulica. Czech Republic: Nemocnice Břeclav (Břeclav): Martin Dohnal; University Hospital Brno (Brno): Jan Malaska, Milan Kratochvil; Municipal Hospital (Havirov): Igor Satinsky, Peter Schwarz; Hospital Karlovy Vary (Karlovy Vary): Zdenek Kos; University Hospital Olomouc (Olomouc): Ladislav Blahut; University Hospital of Ostrava (Ostrava): Jan Maca; Institute for Clinical and Experimental Medicine (Prague): Marek Protus, Eva Kieslichová. Denmark: Odense University Hospital (Odense): Louise Gramstrup Nielsen, Birgitte Marianne Krogh. Ecuador: San Vicente de Paúl Hospital (Ibarra): Francisco Rivadeneira; Hospital Oncologico "Dr. Julio Villacreses Colmont" SOLCA (Portoviejo): Freddy Morales, José Mora; Hospital General Puyo (Puyo): Alexandra Saraguro Orozco; Hospital de Especialidades "Eugenio Espejo" (Quito): Diego Rolando MorochoTutillo, Nelson Remache Vargas; Clinica La Merced (Quito): Estuardo Salgado Yepez; Hospital Militar (Quito): Boris Villamagua. Egypt: Kasr El AINI Hospital, Cairo University (Cairo): Adel Alsisi, Abdelraouf Fahmy. France: CHU Amiens (Amiens): Hervé Dupont; CHU Angers (Angers): Sigismond Lasocki; Hôpital Beaujon (Clichy): Catherine Paugam-Burtz, Arnaud Foucrier; Centre Hospitalier Compiegne Noyon (Compiègne): Alexandru Nica, Geneviève Barjon; Centre Hospitalier de Lens (Lens): Jihad Mallat; Hôpital Edouard Herriot (Lyon): Guillaume Marcotte; Hôpital Nord (Marseille): Marc Leone, Gary Duclos; Clinique du Millénaire (Montpellier): Philippe Burtin; CHU Bichat Claude Bernard (Paris): Philippe Montravers, Enora Atchade; Groupe Hospitalier Paris Saint-Joseph (Paris): Yazine Mahjoub, Benoît Misset; Hôpital Bichat (Paris): Jean-François Timsit, Claire Dupuis; CHU de Rouen, Hôpital Charles Nicolle (Rouen): Benoît Veber; Centre Hospitalier Yves le Foll (Saint-Brieuc): Matthieu Debarre; Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil (Strasbourg): Oliver Collange; Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre (Strasbourg): Julien Pottecher, Stephane Hecketsweiler; Hôpital Cochin (Paris): Mélanie Fromentin, Antoine Tesnière. Germany: University Hospital Giessen (Giessen): Christian Koch, Michael Sander; Universitätsklinikum Schleswig-Holstein (Kiel): Matthias Kott, Gunnar Elke; University Hospital of Leipzig (Leipzig): Hermann Wrigge, Philipp Simon. Greece: General Hospital of Agios Nikolaos (Agios Nikolados): Anthoula Chalkiadaki, Charalampos Tzanidakis; Democritus University of Thrace (Alexandroupolis): Ioannis Pneumatikos, Eleni Sertaridou; Evangelismos Hospital (Athens): Zafiria Mastora, Ioannis Pantazopoulos; Hippocrateion General Hospital of Athens (Athens): Metaxia Papanikolaou, Theonymfi Papavasilopoulou; General Hospital Laiko (Athens): John Floros, Virginia Kolonia; University Hospital Attikon (Athens): George Dimopoulos, Chryssa Diakaki; General Hospital Asklepieio Voulas (Athens): Michael Rallis, Alexandra Paridou; General Hospital G. Gennimatas (Athens): Alexandros Kalogeromitros, Vasiliki Romanou; Konstantopouleio Hospital (Athens): Charikleia Nikolaou, Katerina Kounougeri; Agioi Anargiroi General Oncological Hospital of Kifissia (Athens): Evdoxia Tsigou, Vasiliki Psallida; Red Cross Hospital (Athens): Niki Karampela, Konstantinos Mandragos; General Hospital St George (Chania): Eftychia Kontoudaki, Alexandra Pentheroudaki; Thriassio General Hospital of Eleusis (Eleusis): Christos Farazi-Chongouki, Agathi Karakosta; Giannitsa General Hospital (Giannitsa): Isaac Chouris, Vasiliki Radu; University Hospital Heraklion (Heraklion): Polychronis Malliotakis, Sofia Kokkini; Venizelio General Hospital of Heraklion (Heraklion): Eliana Charalambous, Aikaterini Kyritsi; University Hospital of Ioannina (Ioannina): Vasilios Koulouras, Georgios Papathanakos; General Hospital Kavala (Kavala): Eva Nagky, Clairi Lampiri; Lamia General Hospital (Lamia): Fotios Tsimpoukas, Ioannis Sarakatsanos; Agios Andrea's General Hospital of Patras (Patras): Panagiotis Georgakopoulos, Ifigeneia Ravani; Tzaneio General Hospital (Pireaus): Athanasios Prekates, Konstantinos Sakellaridis; General Hospital of Pyrgos (Pyrgos Hleias): Christos Christopoulos, Efstratia Vrettou; General Hospotal of Rethymnon (Rethymnon): Konstantinos Stokkos, Anastasia Pentari; Papageorgiou Hospital (Thessaloniki): Kostoula Arvaniti, Kyriaki Marmanidou; Hippokration Hospial (Thessaloniki): Christina Kydona, Georgios Tsoumaropoulos; G. Papanikolaou General Hospital (Thessaloniki): Militisa Bitzani, Paschalina Kontou; Agios Pavlos Hospital (Thessaloniki): Antonios Voudouris, Elli-Nikki, Flioni; General Hospital of Thessaloniki G.Gennimatas (Thessaloniki): Elli Antypa, Eleftheria Chasou; Theagenio Anticancer Hospital (Thessaloniki): Souzana Anisoglou, Eirini Papageorgiou; General Hospital of Trikala (Trikala): Theoniki Paraforou, Agoritsa Tsioka; Achillopoyleio General Hospital Volos (Volos): Antigoni Karathanou; Xanthi General Hospital (Xanthi): Aristeidis Vakalos. India: CIMS Hospital (Ahmedabad): Bhagyesh Shah, Chirag Thakkar; CHL Hospitals (Indore): Nikhilesh Jain; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) (Lucknow): Mohan Gurjar, Arvind Baronia; Ruby Hall Clinic (Pune): Prachee Sathe, Shilpa Kulkarni; Jubilee Mission Medical College & Research Institute (Thrissur): Cherish Paul, John Paul. Iran: Nemazi Hospital (Shiraz): Mansoor Masjedi; Anesthesiology and Critical Care Research Centre, Shiraz University of Medical Sciences (Shiraz): Reza Nikandish, Farid Zand; Shiraz Trauma Hospital (Shiraz): Golnar Sabetian; Shohada Hospital (Tabriz): Ata Mahmoodpoor; Masih Daneshvari Hospital (NRITLD (Tehran): Seyed Mohammadreza Hashemian. Israel: Hadassah Hebrew University Medical Centre (Jerusalem): Miklosh Bala. Italy: Cardarelli Ospedale (Campobasso): Romeo Flocco, Sergio Torrente; PinetaGrande Private Hospital (Castel Volturno): Vincenzo Pota; Arcispedale Sant'Anna (Ferrara): Savino Spadaro, Carlo Volta; University Hospital of Modena (Modena): Massimo Girardis, Giulia Serafini; Ospedale S.Antonio (Padova): Sabrina Boraso, Ivo Tiberio; Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone (Palermo): Andrea Cortegiani, Giovanni Misseri; Azienda Ospedaliero-Universitaria di Parma (Parma): Maria Barbagallo, Davide Nicolotti; Azienda Ospedaliero-Universitaria Pisana (Pisa): Francesco Forfori, Francesco Corradi; Fondazione Policlinico Universitario A.Gemelli IRCCS (Roma): Massimo Antonelli, Gennaro De Pascale; Regina Elena National Cancer Institute of Rome (Roma): Lorella Pelagalli; Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette (Torino): Luca Brazzi, Ferdinando Giorgio Vittone; Policlinico Universitario GB Rossi (Verona): Alessandro Russo, Davide Simion; University-Hospital of Foggia (Foggia): Antonella Cotoia, Gilda Cinnella. Jamaica: University Hospital of the West Indies (Kingston): Patrick Toppin, Roxanne Johnson-Jackson. Japan: Kameda General Hospital (Kamogawa): Yoshiro Hayashi, Ryohei Yamamoto; Japanese Red Cross Musashino Hospital (Tokyo): Hideto Yasuda, Yuki Kishihara; Okinawa Prectural Chube Hospital (Uruma, Okinawa): Junji Shiotsuka. Mexico: UMAE Hospital Especialidades Antonio Fraga Mouret-Centro Medico Nacional La Raza IMSS (Mexico City): Luis Alejandro Sanchez-Hurtado, Brigitte Tejeda-Huezo; Hospital Juárez de Mexico (Mexico City): Luis Gorordo; Instituto Nacional de Cancerologia (Mexico City): Silvio A. Ñamendys-Silva, Francisco J. Garcia-Guillen; Hospital general # 5 IMSS (Nogales, Sonora): Manuel Martinez; Hospital Regional de Alta Especialidad de la Península de Yucatán (Merida, Yacatan): Erick Romero-Meja, Ever Colorado-Dominguez. Netherlands: Deventer Hospital (Deventer): Huub van den Oever, Karel Martijn Kalff; Medisch Spectrum Twente (Enschede): Wytze Vermeijden, Alexander Daniel Cornet; Tjongerschans Hospital (Heerenveen): Oliver Beck, Nedim Cimic; Zuyderland Medisch Centrum (Heerlen): Tom Dormans, Laura Bormans; Erasmus MC University Medical Centre (Rotterdam): Jan Bakker, Ditty Van Duijn; Elisabeth-TweeSteden Ziekenhuis (Tilburg): Gerrit Bosman, Piet Vos; University Medical Centre (Utrecht): Dylan de Lange, Jozef Kesecioglu; Diakonessenhuis (Utrecht): Lenneke Haas. Oman: Khoula Hospital (Muscat): Akram Henein. Paraguay: Hospital Regional de Luque (Luque): Ariel M Miranda. Peru: Clínica Ricardo Palma (Lima): Luis Daniel Umezawa Makikado, Gonzalo Ernesto Gianella Malca; Victor Lazarte Echegaray Hospital (Trujillo): Abel Arroyo-Sanchez. Poland: Silesian Hospital Cieszyn (Cieszyn): Agnieszka Misiewska-Kaczur; Wojewodzki Szpital Zesoloby w Koninie (Konin): Frisch Akinyi; First Public Teaching Hospital (Lublin): Miroslaw Czuczwar; Szpital Wojewodzki w Opolu SPZOZ (Opole): Karolina Luczak; SPZZOZ w Ostrowi Mazowieckiej (Ostrow Mazowiecka): Wiktor Sulkowski; Poznan University of Medical Sciences,Regional Hospital in Poznan (Poznan): Barbara Tamowicz, Adam Mikstacki; Centrum Medyczne (Poznan): Beata Swit, Bronisław Baranowski; University Hospital (Poznan): Piotr Smuszkiewicz, Iwona Trojanowska; WSM im. J. Strusia (Poznan): Stanislaw Rzymski; Niepubliczny Zakład Opieki Zdrowotnej Szpital w Puszczykowie im. prof. Stefana Tytusa Dąbrowskiego (Puszczykowo): Mariusz Sawinski, Marta Trosiak; Infant Jesus Teaching Hospital of Warsaw Medical University (Warsaw): Malgorzata Mikaszewska-Sokolewicz. Portugal: Hospital de Braga (Braga): Ricardo Alves, Dina Leal; Centro Hospitalar Algarve (Faro): Andriy Krystopchuk, Pedro Muguel Hilario Mendonca; Centro Hospitalar Universitário Lisboa Central - Hospital Curry Cabral (Lisboa): Rui Antunes Pereira; Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria (Lisboa): Maria Raquel Lopes Marques de Carvalho, Carlos Candeias; Hospital Pedro Hispano (Matosinhos): Elena Molinos, Amélia Ferreira; Centro Hospitalar Sao Joao - Serviço Medicina Intensiva - UCIPU (Porto): Guiomar Castro, José-Artur Paiva; Centro Hospitalar Sao Joao - Serviço Medicina Intensiva - UCIPG (Porto):José-Manuel Pereira; Centro Hospitalar Sao Joao - Infectious Diseases ICU (Porto): Lurdes Santos, Alcina Ferreira; Hospital do Litoral Alentejano (Santiago do Cacém): Dulce Pascoalinho; São Bernardo - Centro Hospitalar Setubal (Setubal): Rosa Ribeiro, Guilherme Domingos; Hospital Vila Franca de Xira (Vila Franca de Xira): Pedro Gomes, David Nora; Centro Hospitalar de Trás-os-Montes e Alto Douro (Vila Real): Rui Pedro Costa, Anabela Santos. Qatar: Hamad Medical Corporation (Doha): Ahmed Subhy Alsheikhly. Romania: Fundeni Clinical Institute (Bucharest): Dana Tomescu, Mihai Popescu; Regional Institute of Oncology (lasi): Ioana Grigoras, Emilia Patrascanu. Russian Federation: Krasnodar Regional Hospital #2 (Krasnodar): Igor Zabolotskikh, Tatiana Musaeva; Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital (Krasnoyarsk): Alexey Gritsan, Denis Gaigolnik; Vishnevsky Institute of Surgery (Moscow): Vladimir Kulabukhov; Privolzhskiy District Medical Centre (Nizhniy Novgorod): Vladislav Belskiy; Clinical Hospital # 4 (Perm): Nadezhda Zubareva, Maxim Tribulev. Saudi Arabia: International Medical Centre (Jeddah): Ahmed Abdelsalam, Ayman Aldarsani; King Faisal Specialist Hospital & Research Centre (Riyadh): Muhammad Al-Khalid; PSMMC (Riyadh): Ghaleb Almekhlafi, Yasser Mandourah. Serbia: Clinical Centre of Serbia (Belgrade): Bojan Jovanovic, Krstina Doklestic; Clinic for Digestive Surgery (Belgrade): Jelena Velickovic, Dejan Velickovic; Clinical Centre Nis, (Nis): Radmilo Jankovic, Anita Vukovic; Oncology Institute of Vojvodina (Sremska Kamenica): Svetlana Skoric-Jokic, Dragana Radovanovic. South Africa: Charlotte Maxeke Johannesburg Academic Hospital (Johannesburg): Guy Richards, Ahmad Alli. Spain: Complejo Hospitalario Universitario de Albacete (Albacete): Maria del Carmen Cordoba Nielfa, Rafael Sánchez Iniesta; Parc de Salut Mar (Barcelona): Adela Benítez-Cano Martínez, Carlos Garcia Bernedo; Hospital Delfos (Barcelona): Santiago Alberto Picos Gil; Vall d'Hebron University Hospital (Barcelona): Xavier Nuvials, Jordi Rello; Hospital Universitario de Basurto (Bilbao): Joseba Gonzalez Garcia, Jose Manuel Garcia Peña; Hospital General Universitario Santa Lucia (Cartagena): Roberto Jimenez, Luis Herrera; Hospital General Universitari de Castelló (Castelló): Laura Galarza Barrachina, Ignacio Catalan Monzon; Hospital General Universitario de Ciudad Real (Ciudad Real): Francisco Javier Redondo, Ruben Villazala; Hospital Costa de la Luz (Huelva): Diego Fernando Matallana Zapata, Isabel Maria Villa Lopez; Hospital Universitari de Bellvitge (L´Hospitalet de Llobregat): Gabriel Moreno-Gonzalez, Juan Carlos Lopez-Delgado; Hospital Universitario de Canarias (La Laguna): Jorge Solera Marin; Hospital Universitario Severo Ochoa (Léganes): Purificacion Sanchez-Zamora; Hospital Universitari Arnau de Vilanova (Lleida): Montserrat Vallverdú Vidal; Hospital Quirón Campo de Gibraltar (Cádiz): Jesús Flores González; Hospital Universitarion del Henares (Madrid): Irene Salinas, Cecilia Hermosa; Hospital Universitario La Paz (Madrid): Emilio Maseda; Hospital Clinico San Carlos (Madrid): Fernando Martinez-Sagasti, Sara Domingo-Marín; Central de la Defensa Gomez Ulla (Madrid): Johanna Abril Victorino; Hospital 12 de Octubre (Madrid): Raquel Garcia-Alvarez, Pablo López-Arcas Calleja; Hospital Universitario de Malaga (Malaga): Maria-Victoria de la Torre-Prados; CHU Ourense (Ourense): Pablo Vidal-Cortes, Lorena del Río-Carbajo; Complejo Hospitalario de Navarra (Pamplona): Javier Izura, Victoria Minguez; Hospital Universitari Mutua Terrassa (Terrassa): Josep Trenado Alvarez, Anna Parera Prous; Complejo Hospitalario de Toledo (Toledo): Daniel Paz; Hospital Verge de la Cinta (Tortosa): Ferran Roche-Campo; Hospital Clínico Universitario de Valencia (Valencia): Gerardo Aguilar, Javier Belda; Rio Hortega University Hospital (Valladolid): Jesus Rico-Feijoo, Cesat Aldecoa; Hospital Clinico Universitario Lozano Blesa (Zaragoza): Begoña Zalba-Etayo. Switzerland: Kantonsspital Frauenfeld (Frauenfeld): Martin Lang; Alexander Dullenkopf. Thailand: Faculty of Medicine Vajira Hospital, Navamindradhiraj University (Bangkok): Konlawij Trongtrakul; Anusang Chtsomkasem. Turkey: Düzce University Hospital (Duzce): Türkay Akbaş; Ankara University School of Medicine (Ankara): Mustafa Necmettin Unal, Menekse Ozcelik; Akdeniz University Medical School (Antalya): Ayca Gumus, Atilla Ramazanoglu; Trakya University Medical Faculty (Edirne): Dilek Memis, Inal Mehmet; Istanbul University-Cerrahpasa, Cerrahpasa Medical School (Istanbul): Yalim Dikmen, Seval Urkmez; Haydarpaşa Numune Training and Research Hospital (Istanbul): Asu Ozgultekin; Istanbul University Cerrahpasa Medical School Hospital (Istanbul): Oktay Demirkiran; Medipol Mega Hospitals Complex (Istanbul): Nesrin Ahu Aslan, Deniz Kizilaslan; Uludag University, School of Medicine (Nilüfer/Bursa): Ferda Kahveci, Nurdan Ünlü; Elazig Training & Research Hospital (Elazig): Zeynep Ozkan. UK: Aberdeen Royal Infirmary (Aberdeen): Callum Kaye, Jan Jansen; Antrim Area Hospital (Antrim): Orla O'Neill, Christopher Nutt; Barnet General Hospital, RFL NHS FT (Barnet): Rajeev Jha, Nicolas Hooker; Basingsoke & North Hampshire Hospital (Basingstoke): Irina Grecu, Christina Petridou; Royal Victoria Hospital (Belfast): Murali Shyamsundar, Lia McNamee; Ulster Hospital (Belfast): John Trinder, Samantha Hagan; Belfast City Hospital (Belfast): Catriona Kelly, Jonathon Silversides; Brighton and Sussex University Hospitals (Brighton): Casiano Barrera Groba, Owen Boyd; West Suffolk Hospital NHS Foundation Trust (Bury St Edmunds): Kaushik Bhowmick, Sally Humphreys; Cambridge University Hospitals NHS Foundation Trust and University of Cambridge (Cambridge): Charlotte Summers, Petra Polgarova; Western Sussex NHS Foundation Trust, St Richard's Hospital (Chichester, West Sussex): Michael Margarson, Justin Dickens; Colchester General Hospital (Colchester): Suzanne Pearson, Elaine Chinery; Altnagelvin Hospital (Derry): Noel Hemmings, Sinead O'Kane; Ninewells Hospital (Dundee): Pauline Austin, Stephen Cole; Medway NHS Foundation Trust (Gillingham): Catherine Plowright, Roberta Box; Queen Elizabeth University Hospital (Glasgow): Christopher Wright, Lorna Young; Royal Surrey County Hospital (Guildford): Ben Creagh-Brown, Laura Montague; Aintree University Hospital (Liverpool): Robert Parker; Ben Morton; Guy's and St Thomas Hospitals (London): Marlies Ostermann, Julia Bilinska; University Hospital Lewisham (London): Bernd Oliver Rose, Rosie Reece-Anthony; St Georges University Hospitals NHS Foundation Trust (London): Christine Ryan, Mark Hamilton; King's College Hospital (London): Philip Hopkins, Julia Wendon; Luton and Dunstable Hospital (Luton): Giovanni Brescia, Nazia Ijaz; Maidstone and Tunbridge Wells NHS Trust Hospital (Maidstone): James Wood, Michelle George; Prince Charles Hospital (Merthyr Tydfil): Piroska Toth-Tarsoly; Northumbria Specialist Emergency Care Hospital (Newcastle Upon Tyne): Bryan Yates, Maureen Armstrong; Royal Victoria Infirmary (Newcastle Upon Tyne): Carmen Scott, Christine Boyd; Royal Gwent Hospital (Newport): Tamas Szakmany, David Rees; Kings Mill Hospital (Nottingham): Paul Pulak, Mandy Coggon; Royal Oldham Hospital (Oldham): Bhaskar Saha, Linda Kent; Royal Glamorgan Hospital (Pontyclun): Bethan Gibson; Poole Hospital NHS FT (Poole): Julie Camsooksai, Henrik Reschreiter; East Surrey Hospital (Redhill): Pat Morgan, Sivatharshini Sangaralingham; Conquest Hospital (St Leonards-on-sea): Alastair Lowe, Petr Vondras; Lister Hospital (Stevenage): Sunil Jamadarkhana, Carina Cruz; University Hospital of North Tees (Stockton-on-Tees): Rakesh Bhandary; Sunderland Royal Hospital (Sunderland): Peter Hersey, Julie Furneval; Musgrove Park Hospital (Taunton): Richard Innes, Patricia Doble; Warwick Hospital (Warwick): Ben Attwood, Penny Parsons; Watford General Hospital (Watford): Valerie Page, Xiaobei Zhao; Royal Hampshire County Hospital (Winchester): Irina Grecu, Julian Dalton. United Arab Emirates: Sheikh Khalifa Medical City (Abu Dhabi): Mohammed Hegazy, Yasser Awad. USA: Cleveland Clinic (Cleveland): Douglas Naylor, Amanda Naylor; Detroit Medical Center (Detroit): Sarah Lee; University of South Alabama Medical Center (Mobile, AL): Sidney Brevard, Noelle Davis. Publisher Copyright: © 2022 Elsevier Ltd
(Peer reviewed)