4 research outputs found
Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19:a multinational, multicentre study, prospective, observational study
- Author
- Albaya-Moreno Antonio
- Bastidas Alirio
- BodĂ MarĂa
- Duque Sara
- DĂaz Ana Maria
- DĂaz Emili
- Estella Ăngel
- Ferrer Ricard
- Figueroa William
- Fuentes Yuli V
- GarcĂa-Gallo Esteban
- Hernandez Glenn
- Ibåñez-Prada Elsa D
- Jibaja Manuel
- Jorge-GarcĂa Ruth
- Loza-Vazquez Ana
- Lozano-Villanueva Jose L
- Martin-Loeches Ignacio
- Moreno Gerard
- Ospina-Tascon Gustavo
- Ramirez-Valbuena Paula C
- Reyes Luis Felipe
- Rodriguez Alejandro
- Sancho Isabel
- Serrano-Mayorga Cristian C
- Shankar-Hari Manu
- Silva Edwin
- Socias Lorenzo
- Solé-Violån Jordi
- VarĂłn-Vega Fabio
- Vera-Alarcon Magdalena
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2023
- Field of study
Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes. Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
- Author
- Abbott TE
- Abdallah RI
- Abdel-Aal IR
- Abdelmonem SA
- Abdo WF
- Abellan AN
- AbellĂĄn AN
- AbellĂĄn AN
- AbellĂĄn AN
- Abrams ST
- Ackerley C
- Acuña M
- Adda M
- Adhikari NK
- Adriano G
- Adrie C
- Affatato R
- Affatato R
- Afonso-Rivero D
- Agarossi A
- Agarwal LK
- Ageeva T
- Agrawal R
- Aguayo-DeHoyos E
- Aguilar AL
- Aguilar-Alonso E
- Aguilar-Alonso E
- Aguilar-Alonso E
- Aguirregabyria M
- Ahmadnia E
- Ahn C
- Ahn JY
- Ahn JY
- Ahn MY
- Ahn MY
- Aitken LM
- Akalaev R
- Akbarzadeh A
- Akcan-Arikan A
- Akhlagh SH
- Akhtar N
- AKI Research Group
- Akiduki N
- Akin S
- Akizuki N
- Akkoc T
- Ala-Kokko T
- Alanio A
- Albaiceta GM
- Albaladejo P
- Alberto F
- Albuisson E
- Alcala MA
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- Aldecoa C
- AlegrĂa L
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- ARIAM registry of adult cardiac surgery
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- Ibsen M
- Idei M
- Idei M
- Idone FA
- Iesu E
- Iesu E
- Iglesias-Santiago A
- Ignacio ML
- Iida A
- Iijima H
- Ilan R
- Ilyina V
- Imanaka H
- Inaloo S
- Ince C
- Iotti GA
- Iotti GA
- Iotti GA
- IPREA Study Group
- Irazabal JM
- Irazabal JM
- Ishimatsu S
- Itenov TS
- Iwamoto M
- Izawa M
- Izdes S
- Jaber S
- Jacky A
- Jacobs FM
- Jacques T
- Jaffal K
- Jamali S
- Jang BH
- Janotka M
- Janotka M
- Janotka M
- Jansen D
- Jansen N
- Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group
- Jardim JJ
- Jardim M
- Jareño A
- Javadpour S
- Jayasinghe S
- Jean-Baptiste S
- Jean-Baptiste S
- Jensen AE
- Jensen JU
- Jeon YD
- Jeon YD
- Jeong IY
- Jeong IY
- Jeong WY
- Jeong WY
- Jian Z
- Jiao LR
- Jibaja M
- Jimenez-Herrera MF
- Jiménez GJ
- Jo YH
- Joachim J
- Jochmans S
- John G
- Jonas M
- Jonas M
- Jonas M
- Jones C
- Joshi R
- Joshi V
- Jovaisa T
- JSEPTIC (Japanese Society of Education for Physicians and Trainees in Intensive Care) Clinical Trial Group
- Juan WC
- Juanas CA
- Judickas S
- Juez A
- Juliarena A
- Jun IG
- Jun IG
- Jung K
- Jung KW
- Junior JM
- Kaczirek K
- Kaese S
- Kalani N
- Kalenka A
- Kalfon P
- Kamali E
- Kaminsky GE
- Kaneko M
- Kang M
- Kang M
- Kang PL
- Kang PL
- Kang PL
- Kang PL
- Kang Y
- Kao KC
- Kappler F
- Kara A
- Karachi F
- Karanjia N
- Karbing DS
- Karsten E
- Kasdan H
- Kashiya S
- Kashyap R
- Katabami K
- Katabami K
- Katabami K
- Katabami K
- Katira BH
- Kavanagh BP
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- Kawano S
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- Kayambu G
- Kazutoshi F
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- Kerr C
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- Khaliq W
- Khine H
- Kim DJ
- Kim HJ
- Kim JM
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- Kim JW
- Kim KS
- Kim KS
- Kim KS
- Kim KS
- Kim MH
- Kim MH
- Kim W
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- Kinnear J
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- Kirakli C
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- Kirwan CJ
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- Kleinpell R
- Kluge S
- Knafelj R
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- Ko JI
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- Kobayashi A
- Koco E
- Kodate A
- Kodate A
- Kodate A
- Kokkini S
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- Komuro T
- Kondili E
- Kongpolprom N
- Kooner G
- Kostalas M
- Kosuk ME
- Kotsopoulos A
- Kou PS
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- Kox M
- Kraegpoeth A
- Krenn CG
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- Kristof J
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- Kubota K
- Kuebler WM
- Kulaga EV
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- Kumari BK
- Kumbamu A
- Kunze-Szikszay N
- Kurmukov IA
- Kurth T
- Kurtz P
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- Kwon HM
- Kwon HM
- Kwon WY
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- Kye YC
- Kyle UG
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- Labaune MA
- Labra C
- Lacerda P
- Laerkner E
- Lafaurie M
- Lafuente E
- Lagonidis D
- Lagos R
- Lahmer T
- Lai CC
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- Latini R
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- Latini R
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- Lischinsky A
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- Lukaszewicz AC
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- Mukherjee DN
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- Okayama Research Investigation Organizing Network (ORION)investigators
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- Spadaro S
- Spadaro S
- Spahn DR
- Spatenkova V
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- Sprung CL
- St Georgeâs University of London
- Stamm J
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- Student Research Committee - Shiraz University of Medical Sciences
- StĂŒmpfle R
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- Suchomel P
- Suh GJ
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- Sung D
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- SĂĄez VC
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- SĂĄnchez MJ
- SĂĄnchez MJ
- SĂĄnchez MJ
- SĂĄnchez MJ
- SĂĄnchez PC
- SĂĄnchez PC
- SĂĄnchez-Elvira LA
- Tabatabaei HR
- Tabei SH
- Taccone F
- Taccone FS
- Taccone FS
- Taccone FS
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- Taccone FS
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- Taggu A
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- Tokyo Womens Medical University
- Tomas E
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- Vaneker I
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- Yoshitake E
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- ZĂœkovĂĄ I
- Ălvarez JT
- Ălvarez-Lerma F
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Meeting abstrac
Recommended from our members
ESICM LIVES 2016: part three: Milan, Italy. 1â5 October 2016
- Author
- Abbott T. E. F.
- Abdallah R. I.
- Abdel-Aal I. R.
- Abdelmonem S. A.
- Abdo W. F.
- Abellan A. Naharro
- AbellĂĄn A. Naharro
- AbellĂĄn A. Navarro
- Abrams S. T.
- Ackerley C.
- Acuña M.
- Adda M.
- Adhikari N. K.
- Adriano G.
- Adrie C.
- Affatato R.
- Afonso-Rivero D.
- Agarossi A.
- Agarwal L. K.
- Ageeva T.
- Agrawal R.
- Aguayo-DeHoyos E.
- Aguilar A. L. Ruiz
- Aguilar-Alonso E.
- Aguirregabyria M.
- Ahmadnia E.
- Ahn C.
- Ahn J. Y.
- Ahn M. Y.
- Aitken L. M.
- Akalaev R.
- Akbarzadeh A.
- Akcan-Arikan A.
- Akhlagh S. H.
- Akhtar N.
- Akiduki N.
- Akin S.
- Akizuki N.
- Akkoc T.
- Ala-Kokko T.
- Alanio A.
- Albaiceta G. Muñiz
- Albaladejo P.
- Alberto F.
- Albuisson E.
- Alcala M. A.
- AlcĂĄzar L.
- Aldabo-Pallas T.
- Aldana N. Navarrete
- Aldecoa C.
- AlegrĂa L.
- Alejandro R.
- Alejo G. Camarena
- Alejos R. MartĂnez
- Alexandrova E.
- Algarte R.
- Algieri I.
- Algora-Weber A.
- Alhamdi Y.
- Aliaga F. A.
- Aliberti S.
- Alkan A.
- Almudena P. MatĂa
- Almudevar P. Matia
- AlmudĂ©var P. MatĂa
- Altıntas N. D.
- Alvarez J.
- Alves S. ChacĂłn
- Alzola L. MeliĂĄn
- Amargianitakis V.
- Amaro R.
- Amato M. B. P.
- Ambler M.
- Amerongen M. P. van Nieuw
- Amininejad T.
- Amor L. Lopéz
- Amorim V.
- Anand R. K.
- Andersen L. W.
- Andersson S.
- Andoh K.
- Andrade A. H.
- Andrade G.
- Andreis D. T.
- Annane D.
- Antonelli M.
- Antoniadou A.
- Antonio C.
- Antonucci E.
- AntĂłn D. GonzĂĄlez
- Anzueto A.
- Appiani F.
- Aquevedo A.
- Aragon C.
- Araujo N. J. FernĂĄndez
- Araujo V. F.
- Arias C. Castro
- Arias N.
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- Arora M. K.
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- Aublanc M.
- Augustin P.
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- Baron A. Vieillard
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- Cardellino S.
- Cardenas C. Lorencio
- Cariou A.
- Carlesso E.
- Carmona A. FernĂĄndez
- Carmona S. Alcantara
- Carmona S. AlcĂĄntara
- Carone M.
- Carpio D.
- CarratalĂĄ A.
- Carreira M. M.
- Carrero-GĂłmez F.
- Carreño E. Renes
- Carreño R.
- Carvalho J. P.
- Carvalho K. V. Silva
- Casals X. Nuvials
- Cassina T.
- Castañeda D. Palacios
- Castellana D.
- Castellanos A.
- Castillo-Lorente E.
- Catalan M.
- CatalĂĄn R. M.
- Catena E.
- Cauwenberghs H.
- Cavalcanti D.
- Cavalheiro A. M.
- Cavalier E.
- Cavicchi F. Zama
- Cengiz M.
- Ceriani R.
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- CeroviÄ O.
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- Chabanne R.
- Chacon-Alves S.
- Champigneulle B.
- Chan K. C.
- Chan K. K. C.
- Chan W. S.
- Chang C. H.
- Chang W. Y.
- Chao A.
- Chao A. S.
- Chao H. C.
- Chaouat M.
- Charitidou E.
- Charpentier C.
- Charpentier J.
- Charron C.
- Chatelon J.
- Chaudhari H. K.
- Chaussard M.
- Chavanon O.
- Chaves S.
- Chelly J.
- Chemam S.
- Chen C. M.
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- Chen G. Q.
- Chen L.
- Chen Y. S.
- Cheng C. C.
- Cheng K. C.
- Cheng Y. J.
- Chernyshuk S.
- Chevret S.
- Chhor V.
- Chiang C. C.
- Chiang C. H.
- Chiappa C.
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- Chondropoulos S.
- Chou W.
- Chouris I.
- Chouvarda I.
- Christopher K. B.
- Chrétien J. M.
- Chumaev A.
- Chung C. R.
- Churchill K.
- Chytas A.
- Cinel I.
- Cinnella G.
- Citerio G.
- Clavel M.
- Clemente E. Aurensanz
- Clermont G.
- Cleyet M.
- Cohen Y.
- Colaprico A.
- Colino L.
- Collange O.
- Colombo A.
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- Combes A.
- Concha P.
- Connolly B.
- Constan A.
- Conte V.
- Conti G.
- Contreras K. M.
- Contreras M. R. Diaz
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- Coombs M.
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- Cordovilla-Guardia S.
- CordĂłn J.
- Corona A.
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- Corte F. Dalla
- Cortes M. L. Blasco
- Corzo L.
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- Costa M. I. Almeida
- Costa R. C.
- Costanzo E.
- Cotoia A.
- Cottini S. R.
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- Cotton H.
- Courant P.
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- Cressoni M.
- Creteur J.
- Crimella F.
- Cron N.
- Cuellar A. I. Vazquez
- Cui N.
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- Curinga M.
- Curtis A.
- Cuthbertson B. H.
- Cutuli S. L.
- CĂąmara M.
- da Silva S. L.
- da Silva V. Z. M.
- Daga-Ruiz D.
- Dalhuisen A.
- Dalorzo M.
- Damas P.
- Dambrosio M.
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- Das Neves A.
- David H.
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- Day A.
- de Abreu M. Gama
- De Backer A.
- De Brito-Ashurst I.
- De Cassai A.
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- De la Calle-Pedrosa N.
- de la Fuente M. Valdivia
- De La Fuente-Martos C.
- De La Rica A. SuĂĄrez
- De la Torre M. A.
- De Maglie M.
- de Molina F. J. GonzĂĄlez
- De Morton N.
- de Oca Sandoval M. A. Montes
- De Pascale G.
- De Rosa S.
- De Sanctis F.
- De Silva A. P.
- De Sousa I.
- de Vera A. Pareja RodrĂguez
- de Wilde W.
- De Zani D.
- Deblier I.
- DeBrunnar R.
- Del Arco A.
- del Moral O. Lopez
- Del Olmo R.
- del Rosario C. GarcĂa
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- Delgado C. Pintado
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- Ălvarez J. Trenado
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 18/11/2016
- Field of study
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- AbellĂĄn Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Akçay Ăzlem
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia GonzĂĄlez
- Aleem Muhammad
- Alegre InĂȘs
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz AmorĂłs
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-DĂez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado FabĂola
- Amador Cristina GarcĂa
- Amanullah Nazli
- Amaral HĂ©lida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- AndrĂ©s Beatriz DĂaz San
- Anestiadou Elissavet
- Ang Chin Wee
- Angelo Franceschi
- Anokhin Evgeny
- Anoldo Pietro
- Antakia Ramez
- Anton Majd
- Antonelli Serena
- Antropoli Carmine
- Anula Rocio
- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
- Aprea Giovanni
- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
- Arican Can
- Arida Zahed Abu
- Armellin Claudia
- Arnaoutoglou Eleni
- Arreguy-Borges Kanthya
- Artigot Mariano
- Arturi Alessandro
- Arulappan Nirupama
- Arya Shobhit
- Arynov Ardak
- Asaad Peter
- Asano Yukio
- Ascari Francesca
- Asgarov Mohsum
- Ashmawy Soad
- Aslam Muhammad Imran
- Assimakopoulou Elena
- Assis Ana
- Astilleta Romina
- Atanasov Boyko
- Atendido Tiffany
- Athanasakis Elias
- Atici Semra Demirli
- Avellaneda Nicholas
- Avellaneda Nicolas
- Avseren Goksu
- Awead Marwa
- Ayandipo Omobolaji
- Aybar Engin
- Aydin Funda
- Aydin Gaye
- Ayoub Kusay
- Aytac Erman
- Aytaç Erman
- Azevedo Jose
- Azevedo Patricia
- Azhar Najia
- Aziz Gowhar
- Azman Zairul Azwan Mohd
- AĆkar Ahmet
- Babatunde Olanrewaju
- Badawi Marwa
- Baek Jeong-Heum
- Baez Noelia FernĂĄndez
- Baeza-Murcia Melody
- Bagnardi Francesco
- Baharom Salahudin
- Baik Seung Hyuk
- Baimakhanov Abylai
- Bains Lovenish
- Baker Aleksandra
- Bakmaz Bernarda
- Bala Abubakar Muhammad
- Balaban Vladimir
- Balalis Dimitrios
- Balasubramaniam Dinesh
- Balathayalan Yathev
- Baldi Claudio
- Balestri Riccardo
- Balfour James
- Ballah Abubakar
- Ballian Nikiforos
- Balooshi Iman Al
- Baloyiannis Ioannis
- Bamford Richard
- Bandar Mahdi Al
- Banham Gail
- Bannoud Mohammad Hassan
- Baptista Victor
- Baral Jörg
- Barbalace Nicolas
- Barbato Giuseppe
- Barbosa Anderson
- Bareka Metaxia
- Baris Baver
- Barradas Renato
- Barreda Sara Castillo
- Barrena-Blazquez Silvestra
- Barton Jess
- Bartosiak Katarzyna
- Bashilkina Olga
- Bashir Mohammed
- Basile Raffaele
- Basnyat Pradeep
- Batool Sana
- Bautista Wilson Manuel SĂĄnchez
- Bayhan ZĂŒlfĂŒ
- Bayo José Manuel Muros
- BayĂłn Raquel Ălvaro
- Baños Pedro Antonio Parra
- Beard David
- Bedzhanyan Arkady
- Behilil Chakib
- Bekele Kebebe
- Belarmino Armin
- Belay Million
- Belev Nikolay
- Bellato Vittoria
- BeltrĂĄn de Heredia Juan
- Belvedere Angela
- Benetti Emilio
- Benetti Sara
- Bengueddach Aicha
- Benjelloun El Bachir
- Benkabbou Amine
- Bennett James
- Bensafir Salim
- Bergamini Carlo
- Bernotaite Vlada
- Beron Reinaldo Isaacs
- Bethune Robert
- Bezede Cosmin
- Beznosenko Andriy
- Bhangu Aneel
- Bhargava Aman
- Bhat Rama Rani Krishna
- Bianchi Romina
- Bianco Francesco
- Bigoni Irene
- Binetti Margherita
- Bintintan Vasile
- Biondi Alberto
- Biondo Santino Antonio
- Bisgin Tayfun
- Bisheet George
- Bissett Ian
- Biswas Jyotirmoy
- Blackwell Sue
- Blanco Pablo
- Blanco Raquel RĂos
- Blanco-Colino Ruth
- Blasco Laura Fraile
- Blazquez-Martin Alma
- Bobadilla Billy Jimenez
- Bocancia Raluca
- Boccia Giuseppe
- Bogatikov Alexander
- Bolanle Olajide Edward
- Bomfa-Barbosa Alysson
- Bompou Effrosyni
- Bonardello Michela
- Bonci Eduard-Alexandru
- Bordom Daniel Osei
- Borges Filipe
- Borghi Felice
- Boschiero Matheus Negri
- Bose Bodhisattva
- Bouchagier Konstantinos
- Boudjenan-Serradj Nabil
- Boudoux Sabrina
- Bourazani Maria
- Boyce Stephen
- Bozbiyik Osman
- Bracale Umberto
- Brachini Gioia
- Bradulskis Saulius
- Brainsa Eneida
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- Yılmaz GĂŒlseren
- Yilmazlar Tuncay
- YiÄit Direnç
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
- ZadroĆŒna Monika
- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah KaÄan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Ălvarez-Llano Laura
- Ăngelo Miguel Duarte
- ĂSullivan Sara Nuñez
- Ăzçelik Mehmet Faik
- Äoza Ivo
- Ćanlı Ahmet Necati
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)