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.