TY - JOUR
T1 - Improved Treatment of Intra-abdominal Abscess
T2 - A Result of Improved Localization, Drainage, and Patient Care, Not Technique
AU - Deveney, Clifford W.
AU - Lurie, Kevin
AU - Deveney, Karen E.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 1988/9
Y1 - 1988/9
N2 - Outcome in patients with abdominal abscesses treated at the University of Pennsylvania, Philadelphia, between 1973 and 1978 (group 1) was compared with that in patients treated between 1981 and 1986 (group 2). Mortality was less in group 2 patients (21% vs 39% in group 1). The decrease in mortality in group 2 was accompanied by a greater percentage of successful predrainage localization (74% vs 55% in group 1), successful initial drainage (76% vs 55% in group 1), and decreased predrainage organ failure (23% vs 52% in group 1). Because failure of initial drainage and predrainage organ failure were associated with increased mortality, improvement in both of these criteria contributed substantially to the lower mortality in group 2 patients. There were no differences in mortality, in initial success in drainage, or in length of hospital stay when 29 group 2 patients who underwent percutaneous drainage were compared with 37 patients who underwent surgical drainage. Mortality (22% vs 21%) and initial success (78% vs 72%) were similar for patients who underwent surgical and percutaneous drainage, respectively. We conclude that initial success in localization and drainage of the abscess is more important than whether drainage is surgical or percutaneous.
AB - Outcome in patients with abdominal abscesses treated at the University of Pennsylvania, Philadelphia, between 1973 and 1978 (group 1) was compared with that in patients treated between 1981 and 1986 (group 2). Mortality was less in group 2 patients (21% vs 39% in group 1). The decrease in mortality in group 2 was accompanied by a greater percentage of successful predrainage localization (74% vs 55% in group 1), successful initial drainage (76% vs 55% in group 1), and decreased predrainage organ failure (23% vs 52% in group 1). Because failure of initial drainage and predrainage organ failure were associated with increased mortality, improvement in both of these criteria contributed substantially to the lower mortality in group 2 patients. There were no differences in mortality, in initial success in drainage, or in length of hospital stay when 29 group 2 patients who underwent percutaneous drainage were compared with 37 patients who underwent surgical drainage. Mortality (22% vs 21%) and initial success (78% vs 72%) were similar for patients who underwent surgical and percutaneous drainage, respectively. We conclude that initial success in localization and drainage of the abscess is more important than whether drainage is surgical or percutaneous.
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U2 - 10.1001/archsurg.1988.01400330106016
DO - 10.1001/archsurg.1988.01400330106016
M3 - Article
C2 - 3415465
AN - SCOPUS:0023707786
SN - 0004-0010
VL - 123
SP - 1126
EP - 1130
JO - Archives of Surgery
JF - Archives of Surgery
IS - 9
ER -