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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. Karer, M. L. M. Uldall Nielsen, N. N. Mujukian, A. Fleshner, P. R. Iesalnieks, I. Pellino, Gianluca Institut Català de la Salut [El-Hussuna A, Karer MLM, Uldall Nielsen NN] Department of Clinical Medicin, Aalborg University, Aalborg, Denmark. [Mujukian A, Fleshner PR] Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA. [Iesalnieks I] Department of Surgery, Städtisches Klinikum München Bogenhausen, Munich, Germany. [Pellino G] Servei de Cirurgia Colorectal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania ‘Luigi Vanvitelli’, Naples, Italy Vall d'Hebron Barcelona Hospital Campus Intestins - Inflamació - Complicacions Abscessos DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease Other subheadings::Other subheadings::Other subheadings::/complications DISEASES::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones ENFERMEDADES::infecciones bacterianas y micosis::infección::supuración::absceso::absceso abdominal Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen Postoperative complications; Drainage Complicacions postoperatòries; Drenatge Complicaciones postoperatorias; Drenaje 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. 2022-04-25T10:35:06Z 2022-04-25T10:35:06Z 2021-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion El-Hussuna A, Karer MLM, Uldall Nielsen NN, Mujukian A, Fleshner PR, Iesalnieks I, et al. Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn’s disease. BJS Open. 2021 Oct;5(5):zrab075. 2474-9842 https://hdl.handle.net/11351/7393 10.1093/bjsopen/zrab075 34518869 000754556000007 http://hdl.handle.net/11351/7393 eng BJS Open;5(5) https://doi.org/10.1093/bjsopen/zrab075 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf image/jpeg Oxford University Press Scientia