Differences in morbidity and mortality with percutaneous versus open surgical drainage of postoperative intra-abdominal infections: A review of 686 cases

Amani D. Politano, Tjasa Hranjec, Laura H. Rosenberger, Robert G. Sawyer, Carlos A. Tache Leon

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Abstract

Intra-abdominal infections following surgical procedures result from organ-space surgical site infections, visceral perforations, or anastomotic leaks. We hypothesized that open surgical drainage is associated with increased patient morbidity and mortality compared with percutaneous drainage. A single-institution, prospectively collected database over a 13-year period revealed 2776 intra-abdominal infections, 686 of which required an intervention after the index operation. Percutaneous procedures (simple aspiration or catheter placement) were compared with all other open procedures by univariate and multivariate analyses. Analysis revealed 327 infections in 240 patients undergoing open surgical drainage and 359 infections in 260 patients receiving percutaneous drainage. Those undergoing open drainage had significantly higher Acute Physiology Score (APS) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores and were more likely to be immunosuppressed, require intensive care unit treatment, and have longer hospital stays. Mortality was higher in the open group: 14.6 versus 4.2 per cent (P = 0.0001). Variables independently associated with death by multivariate analysis were APACHE II, dialysis, intensive care unit (ICU) care, age, immunosuppression, and drainage method. Open intervention for postsurgical intra-abdominal infections is associated with increased mortality compared with percutaneous drainage even after controlling for severity of illness by multivariate analysis. Although some patients are not candidates for percutaneous drainage, it should be considered the preferential treatment in eligible patients.

Original languageEnglish (US)
Pages (from-to)862-867
Number of pages6
JournalAmerican Surgeon
Volume77
Issue number7
StatePublished - Jul 2011

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Intraabdominal Infections
Drainage
Morbidity
Mortality
APACHE
Multivariate Analysis
Intensive Care Units
Surgical Wound Infection
Anastomotic Leak
Infection
Immunosuppression
Dialysis
Length of Stay
Catheters
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Politano, A. D., Hranjec, T., Rosenberger, L. H., Sawyer, R. G., & Tache Leon, C. A. (2011). Differences in morbidity and mortality with percutaneous versus open surgical drainage of postoperative intra-abdominal infections: A review of 686 cases. American Surgeon, 77(7), 862-867.

Differences in morbidity and mortality with percutaneous versus open surgical drainage of postoperative intra-abdominal infections : A review of 686 cases. / Politano, Amani D.; Hranjec, Tjasa; Rosenberger, Laura H.; Sawyer, Robert G.; Tache Leon, Carlos A.

In: American Surgeon, Vol. 77, No. 7, 07.2011, p. 862-867.

Research output: Contribution to journalArticle

Politano, Amani D. ; Hranjec, Tjasa ; Rosenberger, Laura H. ; Sawyer, Robert G. ; Tache Leon, Carlos A. / Differences in morbidity and mortality with percutaneous versus open surgical drainage of postoperative intra-abdominal infections : A review of 686 cases. In: American Surgeon. 2011 ; Vol. 77, No. 7. pp. 862-867.
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