Time to Percutaneous Drain Placement and Impact on Patient Outcomes

Background: 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. Hypothesis: 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. Methods: 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. Results: 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. Conclusion: 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.