Clinical Performance Status and Technical Factors Affecting Outcomes from Percutaneous Transhepatic Biliary Interventions; A Multicentre, Prospective, Observational Cohort Study
| Autor: | Mohammad Ali Husainy, Raman Uberoi, Andrew Wigham, Phil Boardman, Gregory C. Makris, Colin Nice, Hans-Ulrich Laasch, Simon Travis, Teik Choon See, Simon Olliff, Jane Philips Hughes, Rafiudin Patel, Andrew Macdonald, Suzie Anthony, Charles R. Tapping, James E. Cast, Hannah Corrigall, Kader Allouni |
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| Přispěvatelé: | Macdonald, Andrew C [0000-0003-2613-0463], Apollo - University of Cambridge Repository |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Stenting Percutaneous Scoring system Psychological intervention 030218 nuclear medicine & medical imaging Cohort Studies Sepsis 03 medical and health sciences 0302 clinical medicine Informed consent Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Clinical Investigation Prospective Studies Cholestasis business.industry Incidence (epidemiology) Biliary Clinical performance medicine.disease Biliary Tract Surgical Procedures Treatment Outcome 030220 oncology & carcinogenesis Drainage Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | Cardiovascular and Interventional Radiology |
| ISSN: | 1432-086X 0174-1551 |
| Popis: | Funder: British Society of Interventional Radiology PURPOSE: The purpose of this study was to evaluate the predictive value of a 'Modified Karnofsky Scoring System' on outcomes and provide real-world data regarding the UK practice of biliary interventions. MATERIALS AND METHODS: A prospective multi-centred cohort study was performed. The pre-procedure modified Karnofsky score, the incidence of sepsis, complications, biochemical improvement and mortality were recorded out to 30 days post procedure. RESULTS: A total of 292 patients (248 with malignant lesions) were suitable for inclusion in the study. The overall 7 and 30 day mortality was 3.1% and 16.1%, respectively. The 30 day sepsis rate was 10.3%. In the modified Karnofsky 'high risk' group the 7 day mortality was 9.7% versus 0% for the 'low risk' group (p = 0.002), whereas the 30 day mortality was 28.8% versus 13.3% (p = 0.003). The incidence of sepsis at 30 days was 19% in the high risk group versus 3.3% at the low risk group (p = 0.001) CONCLUSION: Percutaneous biliary interventions in the UK are safe and effective. Scoring systems such as the Karnofsky or the modified Karnofsky score hold promise in allowing us to identify high risk groups that will need more careful consideration and enhanced patient informed consent but further research with larger studies is warranted in order to identify their true impact on patient selection and outcomes post biliary interventions. |
| Databáze: | OpenAIRE |
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