Abstract:
HTML
Purpose: To evaluate current practice patterns in percutaneous abscess drainage (PAD) in both academic and private practice settings.
Methods and Materials: 493 surveys were sent to 193 academic (ACA) radiology departments with a residency program and 300 randomly-chosen private practice (PP) radiologists. The survey asked for information on department demographics, details related to patient selection for PAD, methods of anesthesia, methods of performing the procedure including technique and choice of imaging guidance, and post-procedural care.
Results: 95 surveys (49%) were returned from ACA centers and 72 surveys (24%) from PP groups. PAD in ACA is performed by Vascular/Interventional 57%, Body Imaging 26 % and a combination in 16%; in PP a combination performs PAD in 69%. PAD is performed by a fellowship-trained radiologist in 97% of ACA and 79% of PP centers. 59% of ACA and 63% of PP radiologists would not drain a collection measuring less than 3 cm, and 18% of ACA and 69% of PP radiologists would not drain a collection containing gas only. 32% of ACA and 17% of PP radiologists would not perform PAD in a patient with a normal white blood cell count nor a normal temperature in 17% and 11%, respectively. DNR status is also a deterrent to drainage for 11% of the ACA and 23% of the PP radiologists. 95% of ACA and 86% of PP centers use conscious sedation for PAD; those that only use local anesthesia do so because they have no nursing or recovery area in which to monitor patients. The ACA centers use transvaginal and transrectal approaches more frequently than PP (57% and 54% vs. 31% and 29%). Both ACA and PP centers use conventional CT with a higher application of CT fluoroscopy in the ACA centers (40% vs. 23%). Most radiologists use 8-12 F catheters, however the ACA centers use more 14 F catheters (73% vs. 35%).
Conclusion: Although there are distinct differences between academic and private practice settings, PAD is typically performed by radiologists with fellowship training in patients with fluid collections >3 cm in size and appropriate clinical symptoms, under conscious sedation, using CT guidance, with drains ranging in size from 8-12 F.
Questions about this event email: jaffe002@mc.duke.edu
Jaffe MD, T,
Practice Patterns in Percutaneous Intrabdominal Abscess Drainage: A Survey of Academic and Private Practice Centers. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106828.html
