Impact of Bedside Versus Operating Room Drainage on Outcomes of Perianal Abscess: A Two-Center Retrospective Cohort Study With Propensity Score Matching
Kerem Özgü, Ahmet GündüzObjective
To compare 1-year outcomes of bedside and operating-room drainage of perianal abscesses using propensity score methods to address confounding by indication.
Methods
This two-center retrospective cohort included 303 adults undergoing drainage of perianal or anorectal abscesses. Because all bedside procedures involved perianal abscesses, comparative analyses were restricted to 271 patients with perianal abscesses who were potentially eligible for either drainage approach (183 bedside and 88 operating room). We performed 1:1 propensity score matching, inverse probability of treatment weighting (IPTW), and doubly robust analysis using nine baseline covariates.
Results
Propensity score matching yielded 76 pairs. Recurrent abscess occurred in 6.6% of operating-room and 13.2% of bedside patients (OR, 0.38; 95% CI, 0.10-1.41;
Conclusion
A reduction in the co-primary outcomes was not established in the matched or IPTW analyses; their doubly robust findings are exploratory and hypothesis-generating. Reoperation, a prespecified secondary outcome, was consistently less frequent after operating-room drainage. Further prospective studies are warranted.