Incision & drainage of perianal sepsis in the immunocompromised: A need for heightened postoperative awareness

Nicholas P. McKenna, Katherine A. Bews, Omair A. Shariq, Elizabeth B Habermann, Robert R. Cima, Amy Lightner

Research output: Contribution to journalArticle

Abstract

Background: Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown. Methods: 13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and 2015 in the American College of Surgeons National Surgical Quality Improvement Program were identified. The main outcomes were major morbidity, return to the operating room, and mortality. Multivariable analysis was performed for each outcome. Results: Sepsis was the most common postoperative complication. Preoperative immunosuppression was an independent risk factor for major morbidity (odds ratio [OR]: 1.6, p < 0.01), return to the operating room (OR: 1.9, p < 0.01), and mortality (OR: 2.6, p < 0.01). Conclusions: Immunosuppression is an independent risk factor for major morbidity, return to the operating room, and mortality. With post-operative sepsis the most common complication, inpatient admission and extended duration antibiotic therapy is warranted in immunosuppressed patients.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StatePublished - Jan 1 2019

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Drainage
Sepsis
Operating Rooms
Odds Ratio
Morbidity
Immunosuppression
Mortality
Quality Improvement
Population
Inpatients
Anti-Bacterial Agents
Therapeutics

Keywords

  • Immunosuppression
  • Incision and drainage
  • NSQIP
  • Perianal sepsis

ASJC Scopus subject areas

  • Surgery

Cite this

Incision & drainage of perianal sepsis in the immunocompromised : A need for heightened postoperative awareness. / McKenna, Nicholas P.; Bews, Katherine A.; Shariq, Omair A.; Habermann, Elizabeth B; Cima, Robert R.; Lightner, Amy.

In: American Journal of Surgery, 01.01.2019.

Research output: Contribution to journalArticle

McKenna, Nicholas P. ; Bews, Katherine A. ; Shariq, Omair A. ; Habermann, Elizabeth B ; Cima, Robert R. ; Lightner, Amy. / Incision & drainage of perianal sepsis in the immunocompromised : A need for heightened postoperative awareness. In: American Journal of Surgery. 2019.
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