Clinical Performance Status and Technical Factors Affecting Outcomes from Percutaneous Transhepatic Biliary...

Area of Science:

• Interventional Gastroenterology
• Hepatology
• Surgical Oncology

Background:

• Biliary interventions are crucial for managing various hepatobiliary conditions.
• Assessing patient risk pre-procedure is vital for optimizing outcomes.
• The Modified Karnofsky Scoring System offers a potential tool for risk stratification.

Purpose of the Study:

• To evaluate the predictive accuracy of the Modified Karnofsky Scoring System for patient outcomes after biliary interventions.
• To gather real-world data on the practice and safety of percutaneous biliary interventions in the UK.

Main Methods:

• A prospective, multi-centered cohort study involving 292 patients undergoing biliary interventions.
• Data collected included pre-procedure Modified Karnofsky scores, sepsis incidence, complications, biochemical improvement, and mortality up to 30 days post-procedure.

Main Results:

• Overall 7-day and 30-day mortality rates were 3.1% and 16.1%, respectively.
• The 30-day sepsis rate was 10.3%.
• High-risk patients (Modified Karnofsky) showed significantly higher 7-day (9.7% vs 0%) and 30-day (28.8% vs 13.3%) mortality, and a higher 30-day sepsis rate (19% vs 3.3%) compared to low-risk patients.

Conclusions:

• Percutaneous biliary interventions in the UK are demonstrated to be safe and effective.
• The Modified Karnofsky score shows promise in identifying high-risk patients, necessitating careful consideration and enhanced informed consent.
• Further research with larger studies is warranted to fully elucidate the impact of scoring systems on patient selection and outcomes in biliary interventions.