title: Predictors of postoperative outcomes for patients with diverticular abscess initially treated with percutaneous drainage.
abstract: BACKGROUND
  The aim of our study was to evaluate factors associated with percutaneous drainage (PCD) failure, complications, and stoma creation for patients undergoing sigmoidectomy for diverticular abscess.
  
  
  METHODS
  Data for patients with diverticular abscess greater than or equal to 3 cm in diameter treated with initial PCD from 1994 to 2012 were identified.
  
  
  RESULTS
  One hundred fourteen patients (54% male) with a mean age of 57 years and a mean abscess diameter of 7.1 ± 2.4 cm were identified. American Society of Anesthesiologists 4 was the only independent factor associated with PCD failure (P < .001). On multivariate analysis, factors associated with postoperative morbidity (n = 42, 37%) included PCD failure (P = .02) and older age (P = .04), while risk for stoma creation was associated with PCD failure (P < .001), multiple PCD attempts (P = .002), older age (P < .001), Hinchey II (P = .03), and increased body mass index (P = .01). American Society of Anesthesiologists 4 was the only factor associated with permanent stoma (P = .02).
  
  
  CONCLUSIONS
  In patients with large diverticular abscess, a successful PCD is associated with reduced postoperative morbidity. However, a large proportion of patients require stoma creation. Significant comorbidity is associated with both failure of PCD and permanent stoma risk.
authors.affiliation: Department of Colorectal Surgery, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Elagili
authors.affiliation: Department of Colorectal Surgery, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA. Electronic address: stocchl@ccf.org.
authors.forename: Luca
authors.initials: L
authors.lastname: Stocchi
authors.affiliation: Department of Colorectal Surgery, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ozuner
authors.affiliation: Department of Radiology, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA.
authors.forename: Rekha
authors.initials: R
authors.lastname: Mody
authors.affiliation: Department of Radiology, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Baker
authors.affiliation: Department of Colorectal Surgery, the Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, OH, USA.
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Kiran
mesh_terms: D018784:Abdominal Abscess / Q000150:complications / Q000601:surgery*; D004238:Diverticulitis / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
keywords: Diverticular abscess; Percutaneous drainage; Postoperative outcomes; Sigmoid diverticulitis