Intra-abdominal abscess

Assessing risk of adverse outcome and treatment failure[2]Mazuski JE, Tessier JM, May AK, et al. The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surg Infect (Larchmt). 2017 Jan;18(1):1-76. https://www.liebertpub.com/doi/full/10.1089/sur.2016.261 http://www.ncbi.nlm.nih.gov/pubmed/28085573?tool=bestpractice.com

It is important to determine the severity of the IAA infection and stratify the patient's risk at diagnosis, as this influences treatment.

• Assess phenotypic and physiologic factors:

  • Signs of sepsis

  • Extremes of age

  • Comorbidities

  • Extent of abdominal infection and adequacy of source control

  • Presence of resistant or opportunistic pathogen.

• Characterize patients as either low or high risk for treatment failure or mortality.

• Assess for community-acquired or health care-acquired infection.

• Patients with Surviving Sepsis Campaign criteria for sepsis or septic shock, and those with APACHE II score greater than or equal to 10, are at higher risk.

• Prolonged length of hospitalization prior to surgery for intra-abdominal infection.

• Patients with diffuse peritonitis.

• Patients with delayed source control.