Factors associated with a severe intra-abdominal infection:
(1) advanced age
(2) delay in starting an appropriate intervention (> 24 hours)
(3) APACHE II score >= 15 (high severity of illness)
(4) presence of a malignancy
(5) presence of other severe comorbid conditions
(6) hypotension and multiple organ dysfunction
(7) poor nutritional status, including a low serum albumin
(8) diffuse and/or severe peritonitis
(9) inability to adequately debride or drain
(10) unfavorable anatomic location
(11) healthcare-associated infection
where:
• Immunosuppression would be included under comorbid conditions.
• A healthcare-associated infection may involve bacteria that are antibiotic resistant.
The authors state that clinical judgment is at least as accurate as a numerical score for the individual patient.
