Abstract No. 628 Active interventional radiology drainage catheter management reduces drain dwell time and increases percentage of drains removed by interventional radiology

Abstract

To evaluate the effect of active inpatient and outpatient interventional radiology (IR) drainage catheter management on drain dwell time and percentage of drains removed by IR. Retrospective review was performed of drains placed by IR at a tertiary medical center. Exclusion criteria were no documentation of removal, dwell time less than 1 day, and pediatric, seroma, urinoma, or enteric fistula drains. Data collected for the 283 eligible drains included dwell time, IR versus referrer removal, and IR documentation. Statistical analysis was used to compare IR drain management across three phases: passive (January – June 2016), active inpatient/passive outpatient (July 2016 – February 2017) and active all patients (March 2017 – June 2019). Management was still considered passive after June 2016 if drains were lost to IR follow-up or referrer removed without IR involvement. Active inpatient drain management during phase 2 led to a significant 5.6 day decrease in drain dwell time compared to passive management (mean, 12.8 vs. 21.1 days, P <0.01). However, only 43% of drains were actively managed by IR. As a result, there was no significant change in the overall percentage of IR-removed drains compared to phase 1 (31 vs. 25%, P = 0.42). The inclusion of outpatients during phase 3 significantly increased overall active IR drain management (68% vs. 43%, P <0.01) and percentage of IR-removed drains (61% vs. 31%, P <0.01) compared to phase 2. There was also no significant adverse effect on dwell time with the addition of outpatients when compared to phase 2 (mean, 14.1 vs. 12.8 days, P = 0.51). For the entire 42 month analysis period, active IR drain management reduced mean drain dwell time by 4 days (13.7 vs. 17.7 days, P = 0.01) and more than doubled the percentage of IR-removed drains (61 vs. 25%, P <0.01). Active IR drainage catheter management significantly decreases drain dwell time and increases the number of drains removed by IR. Reduction of dwell time has clear value for patients but further study is required to determine if this dwell time reduction and increased IR removal of drains have additional clinical benefits such as avoidance of surgery or recurrent infection.