Purpose or Case Report: To evaluate patient and procedural variables for association with clinical outcomes in pediatric patients receiving IR drains.
Methods & Materials: This retrospective, single-institution study was IRB approved. 111 consecutive pediatric patients (1 day-17 years old, median 10 years old) who underwent abdominal drain placement by IR between 2014-2019 were included. Primary clinical outcomes included number of additional drain placements, complications, length of hospitalization, and repeat drainage within 6 months. Data on drain indication, drain size, presence of fistulae, number of drain changes/upsizing, length of drainage, and location of drain removal was collected. Drain indications were categorized into pre-appendectomy, post-appendectomy, Crohn’s disease, and other.
Results: 34 patients were post-appendectomy, 30 had appendicitis, 3 had Crohn’s disease, and 44 were in the other category. No associations were found between drain indication and drain-related complications (P=0.10) or length of hospitalization (P=0.09). Drain indication correlated with the number of drain changes (P=0.009). Post hoc analysis with Dunn testing revealed other indications to be associated with higher rates of drain changes when compared to appendicitis patients, but after Bonferroni correction, this was not significant. Crohn’s disease also correlated with greater rates of drain changes than appendicitis groups, but there were too few patients to make a meaningful conclusion. Crohn’s disease significantly correlated with need for upsizing (p-value < 0.001), but a conclusive association would require a larger sub-sample. Patients with other indication required drainage on average 5.4 days longer (95% CI [1.95,8.91) than those receiving drains post-appendectomy (p=0.003). No associations were found between drain size and the primary clinical outcomes.

9/111 patients (8.1%) were found to have fistulae. Fistulae significantly correlated with a longer length of drainage by 5.8 days (p=0.04). Fistulae did not correlate with length of hospital stay (p=0.18).

41 drains were removed in IR following fluoroscopic interrogation, 52 were removed inpatient at the bedside, 5 were removed in the operating room, and 12 were removed in clinics. No association was found between removal location and the need for repeat drainage within 6-months (P= 0.63).
Conclusions: Patients receiving percutaneous drains unrelated to appendicitis were generally more complex and fistulae were associated with prolonged drainage times.