EL-HUSSUNA, A., M. L. M. KARER, N. N. ULDALL NIELSEN, A. MUJUKIAN, P. R. FLESHNER, I. IESALNIEKS, N. HORESH, U. KOPYLOV, H. JACOBY, H. M. AL-QAISI, F. COLOMBO, G. M. SAMPIETRO, M. V. MARINO, M. ELLEBÆK, C. STEENHOLDT, N. SØRENSEN, V. CELENTANO, N. LADWA, J. WARUSAVITARNE, G. PELLINO, A. ZEB, F. DI CANDIDO, L. HURTADO-PARDO, M. FRASSON, Lumír KUNOVSKÝ, A. YALCINKAYA, O. C. TATAR, S. ALONSO, M. PERA, A. G. GRANERO, C. A. RODRÍGUEZ, A. MINAYA, A. SPINELLI and N. QVIST. Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease. BJS Open. Oxrford: Oxford University Press, 2021, vol. 5, No 5, p. 1-9. ISSN 2474-9842. Available from: https://dx.doi.org/10.1093/bjsopen/zrab075.
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Basic information
Original name Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease
Authors EL-HUSSUNA, A., M. L. M. KARER, N. N. ULDALL NIELSEN, A. MUJUKIAN, P. R. FLESHNER, I. IESALNIEKS, N. HORESH, U. KOPYLOV, H. JACOBY, H. M. AL-QAISI, F. COLOMBO, G. M. SAMPIETRO, M. V. MARINO, M. ELLEBÆK, C. STEENHOLDT, N. SØRENSEN, V. CELENTANO, N. LADWA, J. WARUSAVITARNE, G. PELLINO, A. ZEB, F. DI CANDIDO, L. HURTADO-PARDO, M. FRASSON, Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), A. YALCINKAYA, O. C. TATAR, S. ALONSO, M. PERA, A. G. GRANERO, C. A. RODRÍGUEZ, A. MINAYA, A. SPINELLI and N. QVIST.
Edition BJS Open, Oxrford, Oxford University Press, 2021, 2474-9842.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30212 Surgery
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 3.875
RIV identification code RIV/00216224:14110/21:00123028
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1093/bjsopen/zrab075
UT WoS 000754556000007
Keywords in English smoking; crohn's disease; postoperative complications; abdominal abscess; abscess; surgical procedures; operative
Tags 14110213, 14110223, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 28/2/2022 13:32.
Abstract
Background In patients with active Crohn’s disease (CD), treatment of intra-abdominal abscess usually comprises antibiotics and radiologically guided percutaneous drainage (PD) preceding surgery. The aim of this study was to investigate the risk of postoperative complications and identify the optimal time interval for surgical intervention after PD. Methods A multicentre, international, retrospective cohort study was carried out. Details of patients with diagnosis of CD who underwent ultrasonography- or CT-guided PD were retrieved from hospital records using international classification of disease (ICD-10) diagnosis code for CD combined with procedure code for PD. Clinical variables were retrieved and the following outcomes were measured: 30-day postoperative overall complications, intra-abdominal septic complications, unplanned intraoperative adverse events, surgical-site infections, sepsis and pathological postoperative ileus, in addition to abscess recurrence. Patients were categorized into three groups according to the length of the interval from PD to surgery (1–14 days, 15–30 days and more than 30 days) for comparison of outcomes. Results The cohort comprised 335 CD patients with PD followed by surgery. Median age was 33 (i.q.r. 24–44) years, 152 (45.4 per cent) were females, and median disease duration was 9 (i.q.r. 3.6–15) years. Overall, the 30-day postoperative complications rate was 32.2 per cent and the mortality rate was 1.5 per cent. After adjustment for co-variables, older age (odds ratio 1.03 (95 per cent c.i. 1.01 to 1.06), P < 0.012), residual abscess after PD (odds ratio 0.374 (95 per cent c.i. 0.19 to 0.74), P < 0.014), smoking (odds ratio 1.89 (95 per cent c.i. 1.01 to 3.53), P = 0.049) and low serum albumin concentration (odds ratio 0.921 (95 per cent c.i. 0.89 to 0.96), P < 0.001) were associated with higher rates of postoperative complications. A short waiting interval, less than 2 weeks after PD, was associated with a high incidence of abscess recurrence (odds ratio 0.59 (95 per cent c.i. 0.36 to 0.96), P = 0.042). Conclusion Smoking, low serum albumin concentration and older age were significantly associated with postoperative complications. An interval of at least 2 weeks after successful PD correlated with reduced risk of abscess recurrence.
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