Intra-abdominal infections at Tartu University Hospital: changes in the last 10 years

BACKGROUND/OBJECTIVE. Marked changes have occurred in the diagnosis, and in the initial and surgical treatment of intraabdominal infections (IAI) in recent years. The aim of this study was to assess these changes at Tartu University Hospital for the last decade.

METHODS. This is a retrospective study analysing all patients with IAI treated at Tartu University Hospital in 1997 and 2007.

RESULTS. Altogether 159 patients with IAI were treated in 1997 and 173 patients were treated in 2007 at Tartu University Hospital. The incidence of IAI was 5.5 and 5.8 per 10,000 inhabitants, respectively. The age of the patients increased by 4.4 years during the observation decade and the rate of concomitant diseases increased from 18.9% to 31.2%. In 2007 there were  significantly less patients with perforated pepticulcer (40 vs 23) and more patients with IA abscesses compared to 1997 (33 vs 51). In diagnostic imaging the use ofult rasonography (US) and computed tomography (CT) increased significantly (from 26.8% to 70.1% and from 2.8% to 33.8%, respectively). Two significant changes occurred in treatment: in 2007, 47.8% of the patients with perforated pepticulcer were treated laparoscopically (none in 1997) and 45.1% of the patients with IA abscesses were drained percutaneously (none in 1997). Mortality rate was almost constant, 8.2% and 8.7%, respectively.

CONCLUSIONS. Patients with IAI treated at present are older and have more concomitant diseases. Despite this, better diagnostic imaging and new treatment methods have enabled to maintain the relatively low mortality rate.

Eesti Arst 2010; 89(1):13−20