Influence of diabetes and obesity on the risk of recurrence or anal fistula in patients with perianal abscess after simple incision and drainage
10.3760/cma.j.cn115807-20240219-00047
- VernacularTitle:糖尿病及肥胖对肛周脓肿患者单纯切开引流术后复发或并发肛瘘风险的影响
- Author:
Honglan SUN
1
;
Deming YU
;
Huifeng LIU
;
Changliang CHEN
;
Nan LI
Author Information
1. 首都医科大学附属北京潞河医院普外科，北京 101100
- Keywords:
Perianal abscess;
Simple incision and drainage;
Postoperative recurrence;
Anal fistula;
Diabetes;
Obesity
- From:
Chinese Journal of Endocrine Surgery
2024;18(3):358-362
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the interaction effect of diabetes and obesity on recurrence or anal fistula in patients with perianal abscess after simple incision and drainage.Methods:The clinical data of 163 patients with perianal abscess who underwent simple incision and drainage from Jun. 2021 to Jun. 2023 were analyzed retrospectively. The incidence of recurrence or anal fistula in 6 months after surgery was calculated. Multivariate Logistic regression model was used to analyze the influencing factors of postoperative recurrence or anal fistula. The multiplicative and additive models were used to analyze the interaction effect of diabetes and obesity on the risk of postoperative recurrence or anal fistula.Results:In 6 months after simple incision and drainage, the incidence of recurrence or anal fistula was 28.22% (46/163). Univariate analysis results showed that gender, obesity, and diabetes were related to recurrence of perianal abscess or incidence of anal fistula ( P<0.05). Multivariate Logistic regression analysis results showed that obesity ( OR=2.447, 95% CI: 1.320-4.538) and diabetes ( OR=2.162, 95% CI: 1.187-3.938) were independent risk factors for postoperative recurrence or anal fistula ( P<0.05). Interaction effect analysis found that after adjusting for confounding factors, diabetes and obesity had additive interaction effect on the risk of postoperative recurrence or anal fistula. The relative excess risk due to interaction (RERI), attribution percentage (AP), and interaction effect index (S) were 1.829 (95% CI: 0.605-3.007), 0.405 (95% CI: 0.143-0.597), and 2.098 (95% CI: 1.201-3.172), respectively. There was no multiplicative interaction effect between the two ( P>0.05) . Conclusions:Diabetes and obesity are independent risk factors for recurrence or anal fistula in patients with perianal abscess after simple incision and drainage. The two may have synergistic effect on the risk of postoperative recurrence or anal fistula.
