The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001).

1st Clinic of General Surgery University Hospital UMBAL St George Plovdiv Plovdiv Bulgaria

2 Cátedra de Clínica Quirúrgica Hospital de Clínicas Asuncion Paraguay

3rd Department of General Surger Jagiellonian Univeristy Narutowicz Hospital Krakow Poland

American Board of Surgery Philadelphia USA

Clinical and Experimental Sciences Brescia Ospedali Civili Brescia Italy

Clinical Sciences Regional Hospitals Limbe and Buea Limbe Cameroon

Department of Abdominal Surgery University Hospital Meilahti Helsinki Finland

Department of Acute and Critical care medicine Tokyo Medical and Dental University Tokyo Japan

Department of Anestesiology Ospedali Riuniti Bergamo Italy

Department of Emergency and Critical Care Medicine Chiba University Hospital Chiba Japan

Department of Emergency and Critical Care Medicine Chiba University Hospital Chiba Japan ; Depatment of Emergency Medicine Kyoto 2nd Red Cross Hospital Kyoto Japan

Department of General and Digestive Surgery Virgen de la Victoria University Hospital Malaga Spain

Department of General Surgery and Surgical Oncology Université de Nice Sophia Antipolis Universitary Hospital of Nice Nice France

Department of General Surgery Hadassah Medical Center Jerusalem Israel

Department of General Surgery Lviv Emergency Hospital Lviv Ukraine

Department of General Surgery Ospedali Riuniti Bergamo Italy

Department of General Surgery Rambam Health Care Campus Haifa Israel

Department of Primary Care and Emergency Medicine Kyoto University Graduate School of Medicine Kyoto Japan

Department of Surgery Adria Hospital Adria Adria Italy

Department of Surgery Ahmadu Bello University Teaching Hospital Zaria Kaduna Nigeria

Department of Surgery Ancona University Ancona Italy

Department of Surgery Bahrain Defence Force Hospital Manama Bahrain

Department of Surgery Chang Gung Memorial Hospital Taoyuan Taiwan

Department of Surgery Cutral Có Clinic Cutral Có Argentina

Department of Surgery Denver Health Medical Center Denver USA

Department of Surgery Edendale Surgery Pietermaritzburg Republic of South Africa

Department of Surgery Emergency Unit Ribeirão Preto Brazil

Department of Surgery Faculdades Integradas Padre Albino Catanduva Brazil

Department of Surgery Faculty of Medicine Siriraj Hospital Bangkok Thailand

Department of Surgery Fundación Valle del Lilí Cali Colombia

Department of Surgery Govt Medical College and Hospital Chandigarh India

Department of Surgery Hospital and Oncological Centre Novy Jicin Czech Republic

Department of Surgery Hospital Regional de Alta Especialidad del Bajio Leon Mexico

Department of Surgery Kovai Medical Center Coimbatore India

Department of Surgery Macerata Hospital Macerata Italy

Department of Surgery Maggiore Hospital Bologna Italy

Department of Surgery Mansoura University Hospital Mansoura Egypt

Department of Surgery Mayo General Hospital Castlebar Co Mayo Castlebar Ireland

Department of Surgery Mazzoni Hospital Ascoli Piceno Italy

Department of Surgery Mellini Hospital Chiari BS Italy

Department of Surgery Monte Sinai Hospital Juiz de Fora Brazil

Department of Surgery MOSC Medical College Cochin India

Department of Surgery Mozyr City Hospital Mozyr Belarus

Department of Surgery Obafemi Awolowo UNiversity Hospital Ile Ife Nigeria

Department of Surgery Our Lady of Lourdes Hospital Drogheda Ireland

Department of Surgery Port Shepstone Hospital Port Shepstone South Africa

Department of Surgery Pt BDS Post graduate Institute of Medical Sciences Rohtak India

Department of Surgery Ripas Hospital Bandar Seri Begawan Brunei

Department of Surgery Severance Hospital Yonsei University College of Medicine Seoul Republic of Korea

Department of Surgery SKIMS Srinagar India

Department of Surgery Thammasat University Hospital Pathumthani Thailand

Department of Surgery Tianjin Nankai Hospital Nankai Clinical School of Medicine Tianjin Medical University Tianjin China

Department of Surgery UC San Diego Health System San Diego USA

Department of Surgery University Hospital Center Zagreb Zagreb Croatia

Department of Surgery University of Newcastle Newcastle NSW Australia

Division of Trauma and Surgical Critical Care Department of Surgery University of Ulsan Seoul Republic of Korea

Division of Trauma Critical Care Department of Surgery Virginia Commonwealth University Richmond VA USA

Division of Trauma Emergency Surgery and Surgical Critical Care Harvard Medical School Massachusetts General Hospital Massachusetts USA

Division of Trauma Surgery Campinas University Campinas Brazil

Emergency and Critical Care Center of Nippon Medical School Tama Nagayama Hospital Tokyo Japan

Emergency and Critical Care Medicine Jichi Medical University Shimotsuke Japan

Emergency Surgery Maggiore Parma Hospital Parma Italy

General Surgery Adana Numune Training and Research Hospital Adana Turkey

Tajima emergency and Critical Care Medical Center Toyooka Public Hospital Toyooka Hyogo Japan

The Shock Trauma and Emergency Medical Center Matsudo City Hospital Chiba Japan

Trauma Surgery Unit Maggiore Hospital Bologna Italy

Visceral Surgery Military Hospital Desgenettes Lyon France

Visceral Surgery Teaching Hospital Yalgado Ouedraogo Ouedraogo Burkina Faso

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