Percutaneous drains are a commonly used method of source control for intra-abdominal infections. Increased time to source control has been shown to predict worse outcomes in patients with intra-abdominal infections, but it is unclear whether this relationship is valid when the source control method is percutaneous drainage. We hypothesized that increased time from diagnostic imaging to drain placement would be associated with higher complication rates in a population of patients requiring percutaneous drainage for intra-abdominal, retroperitoneal, or pelvic infectious processes. We identified all adult patients who received a percutaneous drain placed by interventional radiology that had positive microbial drain culture results in the abdomen, retroperitoneum, or pelvis from 2020 to 2021 at the University of Kansas Medical Center. Demographics, comorbidities, and Sequential Organ Failure Assessment (SOFA) scores were collected. Multiple organ failure was defined as derangement of two or more organ systems with an SOFA ≥ 3. Standard univariate and logistic regression analyses were performed. One hundred seventy patients were included, 94 of whom developed a complication (52%). Drain placement occurred at a median of 20.6 hours (inter-quartile range or IQR: 11.3-31.0 h) overall. Both uni-variable and logistic regression analyses demonstrate that time from imaging read to drain placement did not differ between the complication and non-complication groups. In this observational study, the time from diagnosis of intra-abdominal infection to percutaneous drain placement was not associated with increased complication rates even in the sickest patients.
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http://dx.doi.org/10.1089/sur.2024.231 | DOI Listing |
Surg Infect (Larchmt)
March 2025
Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Percutaneous drains are a commonly used method of source control for intra-abdominal infections. Increased time to source control has been shown to predict worse outcomes in patients with intra-abdominal infections, but it is unclear whether this relationship is valid when the source control method is percutaneous drainage. We hypothesized that increased time from diagnostic imaging to drain placement would be associated with higher complication rates in a population of patients requiring percutaneous drainage for intra-abdominal, retroperitoneal, or pelvic infectious processes.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
March 2025
Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California.
Background: Gangliogliomas are low-grade gliomas typically found in the temporal lobes with a low rate of malignant transformation. In rare cases, they may be found in the spinal axis.
Observations: An 8-year-old boy presented with 2 months of neck pain and upper extremity incoordination and was found to have a cervicomedullary lesion.
Objective: Evaluate the postoperative pain management of patients at a single institution following routine thyroid and parathyroid surgery and compare patient opioid use before and after a practice wide quality improvement change.
Study Design: Retrospective chart review with prospective survey administration.
Setting: University of New Mexico Hospital.
Surg Neurol Int
February 2025
Department of Neurosurgery and Neuroendovascular Therapy, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.
Background: Middle cranial fossa arachnoid cysts (MFACs) cause subdural hygromas due to head trauma or spontaneous rupture. We report the case of a patient who has performed burr hole surgery for subdural hygroma and chronic subdural hematoma (CSDH) caused by the rupture of an arachnoid cyst.
Case Description: A 30-year-old man fell off a motorbike and hit his head.
Background: Prophylactic drain use during primary bariatric surgeries continues despite previous literature cautioning against their routine use. Modern drain utilization and associated outcomes remain largely poorly studied which limits selective utilization and perhaps may lead to excess morbidity and healthcare resource utilization. This study aimed to reassess current trends of drain use in primary bariatric procedures, factors driving surgeons to place drains, and patient outcomes associated with drain placement.
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