Endoscopic retrograde cholangiopancreatography sonrası gelişen bakteriyemide eşlik eden risk faktörleri

Year 2020, , 48 - 52, 02.01.2020

Ayhanım Tümtürk , Cigdem Ataman Hatipoglu

https://doi.org/10.28982/josam.673577

Abstract

Amaç: Endoskopik retrograd kolanjiyopankreatografi (ERCP) sonrası bakteriyemi ciddi bir komplikasyondur, ancak bu komplikasyon için risk faktörleri henüz net olarak tanımlanmamıştır. Bu çalışmada ERCP sonrası bakteriyemi ve ilişkili risk faktörlerinin insidansını belirlemeyi amaçladık.

Yöntemler: Bu retrospektif-kohort çalışma Ocak 2017-Aralık 2018 tarihleri arasında yapıldı. İşlem öncesi enfeksiyon belirtisi olmayan ve işlem sonrası bakteriyemi gelişen hastalar çalışmaya alındı. Bakteriyemi gelişen her hasta için ERCP uygulanan ve bakteriyemi geliştirmeyen iki randomize kontrol hastası risk faktörlerini, klinik ve laboratuvar bulgularını karşılaştırmak için seçildi.

Bulgular: ERCP prosedürü uygulanan 4237 hastanın 86'sında toplam 91 bakteriyemi atağı tespit edildi. ERCP sonrası bakteriyemi oranı % 2 olarak bulundu. Çok değişkenli analizde, hastanın yaşı, safra yolları kanseri, kolesistit / kolanjit, pankreatit ve biyopsi bakteriyemi için anlamlı risk faktörleri olarak bulundu (sırasıyla P=0,009, P<0,001, P=0,008, P=0,002 ve P=0,014) .

Sonuç: ERCP sonrası bakteriyemi gelişimi mortalite riskini önemli ölçüde artırmaktadır. Çalışmamızda, kaybedilen hastaların yaş ortalaması daha büyüktü. Bu sonuç, özellikle yaşlı hastalarda profilaktik antibiyotik kullanımını destekler niteliktedir. Potansiyel ERCP komplikasyonları ve risk faktörleri hakkındaki bilgi sahibi olmanın, komplikasyon insidansını ve şiddetini azaltmaya yardımcı olabileceğini düşünüyoruz.

Keywords

Endoscopic retrograde cholangiopancreatography, Bakteriyemi, Risk faktörleri

Risk factors for bacteremia following endoscopic retrograde cholangiopancreatography

Abstract

Aim: Bacteremia after endoscopic retrograde cholangiopancreatography (ERCP) is a serious complication, but its risk factors have not yet been clearly defined. In this study, we aimed to determine the incidence of bacteremia and associated risk factors after ERCP.

Methods: This retrospective-cohort study was conducted between January 2017 and December 2018. Patients who had no signs of infection before the procedure and who developed bacteremia after the procedure were included in the study. For each patient who developed bacteremia, two randomized control patients who underwent ERCP and did not develop bacteremia were selected to compare risk factors, clinical and laboratory findings. 

Results: A total of 91 bacteremia attacks were detected in 86 of the 4237 patients who underwent ERCP procedure. Bacteremia rate after ERCP was 2%. In multivariate analysis, the age of the patient, presence of biliary tract cancer, cholecystitis / cholangitis, pancreatitis and biopsy were determined as significant risk factors for post-ERCP bacteremia (P=0.009, P<0.001, P=0.008, P=0.002 and P=0.014 respectively). 

Conclusion: The development of bacteremia after ERCP significantly increases the risk of mortality. The mean age of the patients who died was older. This result supports the use of prophylactic antibiotics especially in elderly patients. We think that knowledge of potential ERCP complications and risk factors may help reduce the incidence and severity of complications.

Keywords

Endoscopic retrograde cholangiopancreatography, Bacteremia, Risk factors

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