Early Predictors For Recovery Of Percutaneous Catheter Drainage In Pyogenic Liver Abscess Patients

Purpose To identify early predictors for recovery of percutaneous catheter drainage(PCD)in pyogenic liver abscess(PLA)patients and develop an effective prognostic nomogram.Materials and Methods This retrospective study comprised PLA patients treated with PCD in two hospitals,including the patients of Zhongda Hospital,Southeast University from March 2010 to February 2017 and First Affiliated Hospital of Soochow University from July 2012 to February 2017.We defined overall recovery time(ORT)as the time from PCD procedure to clinical success,which was determined by symptoms,inflammatory index,drainage output and radiological re-examination.The main outcome measures were demographics,clinical features,preoperative imaging characteristics,procedural details and clinical outcomes.Based on the ORT,early predictors of recovery were identified with univariate and multivariate analyses,and a prognostic nomogram was developed to predict the period to recovery and internally validated using the concordance statistic(Harrell's c statistic).Results One hundred and fourteen patients with a median ORT of 16.0±16.0 days were included in this study.Abscess with biliary origin(ABO;HR: 0.464 [95% CI] 0.306-0.706;P<0.001),diabetes mellitus(DM;HR: 0.585;[95% CI] 0.398-0.861;P=0.007)and preinterventional septic shock(PSS;HR: 0.361;[95% CI] 0.190-0.687;P=0.002)were identified as early predictors after univariate and multivariate analyses,which with median ORT significantly longer than those patients without.The prognostic analyses demonstrated that the more predictors(ABO,DM and PSS)a patient exhibited,the longer ORT for the PCD therapy.A prognostic nomogram was developed based on those three predictors,and showed high accuracy,with a Harrell's c statistic of 0.66.Conclusion ABO,DM and PSS were early predictors for recovery of PCD in PLA patients.