Postoperative complications and waiting time for surgical
intervention after radiologically guided drainage of
intra-abdominal abscess in patients with Crohn's disease

J 2021

Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease

EL-HUSSUNA, A., M. L. M. KARER, N. N. ULDALL NIELSEN, A. MUJUKIAN, P. R. FLESHNER et. al.

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

Edition

BJS Open, Oxrford, Oxford University Press, 2021, 2474-9842

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

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

Abstract

V originále

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.

Citovat

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.

@article{1806120,
   author = {ElandHussuna, A. and Karer, M. L. M. and Uldall Nielsen, N. N. and Mujukian, A. and Fleshner, P. R. and Iesalnieks, I. and Horesh, N. and Kopylov, U. and Jacoby, H. and AlandQaisi, H. M. and Colombo, F. and Sampietro, G. M. and Marino, M. V. and Ellebæk, M. and Steenholdt, C. and Sørensen, N. and Celentano, V. and Ladwa, N. and Warusavitarne, J. and Pellino, G. and Zeb, A. and Di Candido, F. and HurtadoandPardo, L. and Frasson, M. and Kunovský, Lumír and Yalcinkaya, A. and Tatar, O. C. and Alonso, S. and Pera, M. and Granero, A. G. and Rodríguez, C. A. and Minaya, A. and Spinelli, A. and Qvist, N.},
   article_location = {Oxrford},
   article_number = {5},
   doi = {http://dx.doi.org/10.1093/bjsopen/zrab075},
   keywords = {smoking; crohn's disease; postoperative complications; abdominal abscess; abscess; surgical procedures; operative},
   language = {eng},
   issn = {2474-9842},
   journal = {BJS Open},
   title = {Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease},
   url = {https://academic.oup.com/bjsopen/article/5/5/zrab075/6369776},
   volume = {5},
   year = {2021}
}

TY  - JOUR
ID  - 1806120
AU  - El-Hussuna, A. - Karer, M. L. M. - Uldall Nielsen, N. N. - Mujukian, A. - Fleshner, P. R. - Iesalnieks, I. - Horesh, N. - Kopylov, U. - Jacoby, H. - Al-Qaisi, H. M. - Colombo, F. - Sampietro, G. M. - Marino, M. V. - Ellebæk, M. - Steenholdt, C. - Sørensen, N. - Celentano, V. - Ladwa, N. - Warusavitarne, J. - Pellino, G. - Zeb, A. - Di Candido, F. - Hurtado-Pardo, L. - Frasson, M. - Kunovský, Lumír - Yalcinkaya, A. - Tatar, O. C. - Alonso, S. - Pera, M. - Granero, A. G. - Rodríguez, C. A. - Minaya, A. - Spinelli, A. - Qvist, N.
PY  - 2021
TI  - Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease
JF  - BJS Open
VL  - 5
IS  - 5
SP  - 1-9
EP  - 1-9
PB  - Oxford University Press
SN  - 24749842
KW  - smoking
KW  - crohn's disease
KW  - postoperative complications
KW  - abdominal abscess
KW  - abscess
KW  - surgical procedures
KW  - operative
UR  - https://academic.oup.com/bjsopen/article/5/5/zrab075/6369776
N2  - 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.
ER  -

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. \textit{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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