Analysis of risk factors for the failure of retroperitoneal percutaneous catheter drainage for infected pancreatic necrosis

Yani SUN; Yun SUN; Lijun CAO; Zhonghua LU; Pinjie ZHANG

ABSTRACT

Objective:

To study the risk factors for the failure of retroperitoneal percutaneous catheter drainage (PCD) for infected pancreatic necrosis (IPN).

Methods:

The clinical data of 68 patients with IPN treated with PCD in the Second Affiliated Hospital of Anhui Medical University from January 2019 to April 2023 were retrospectively analyzed, including 43 males and 25 females, aged (49.0±16.3) years old. Patients were divided into the PCD success group ( n=26) and PCD failure group ( n=42). The score of disease severity and laboratory indices before PCD and the vital organ function scores and enteral nutrition tolerance 48 hours after PCD were collected and accessed by univariate analysis, and factors with P<0.05 were included in the logistic multivariate regression analysis for the risk factors of PCD failure.

Results:

There were statistical significance in the acute physiological and chronic health status (APACHE Ⅱ) score within 24 hours of admission; the modified CT severity index (MCTSI) score, time of enhanced CT scan, acute kidney injury, acute respiratory distress syndrome (ARDS), and the total amount of noradrenaline before first PCD; the APACHE II score and sequential organ failure (SOFA) score within 48 hours after first PCD; and the culture results of drainage and start of enteral nutrition in the two groups (all P<0.05). Multifactorial logistic regression analysis showed that the occurrence of ARDS before first PCD ( OR=4.682, 95% CI 1.010-21.692, P=0.048), the delayed start of enteral nutrition ( OR=1.286, 95% CI 1.020-1.622, P=0.033), the high MCTSI score before first PCD ( OR=2.125, 95% CI 1.198-3.767, P=0.010), and high SOFA score within 48 hours after first PCD ( OR=1.579, 95% CI 1.142-2.183, P=0.006) were independent risk factors for the failure of PCD.

Conclusion:

Patients with ARDS before first PCD, high MCTSI score before first PCD, high SOFA score within 48 hours after first PCD, and the delayed start of enteral nutrition were risk factors for the failure of PCD for IPN.