Prognostic factors of recurrence or anal fistula formation following the drainage of anorectal abscess

doi:10.3877/cma.j.issn.2095-3224.2021.05.007

Abstract

Abstract:

Objective

To investigate the prognostic factors leading to the recurrence of abscess or anal fistula formation in patients with anorectal abscess following the drainage.

Methods

This study included 303 subjects with first-time anorectal abscess who underwent drainage in our hospital from January 2017 to December 2019. Multivariate Cox regression analysis was used to identify the prognostic factors leading to the recurrence of abscess or anal fistula formation following the drainage.

Results

The results showed that 120 (39.6%) subjects had a recurrent or developed anal fistula and 183 (60.4%) were cured during the follow-up period. The cumulative cure rates were 74.6%, 67.3%, 62.0% for 1, 2, 3 years following the drainage, respectively. Female (HR=1.759, P=0.014), obesity (HR=4.886, P＜0.001) and horseshoe abscess (HR=2.431, P＜0.001) are risk factors for recurrence of anorectal abscess or anal fistula formation.

Conclusion

Gender, obesity index and horseshoe abscess are closely related to the prognosis of patients with anorectal abscess. Individualized prevention and treatment should be given for different patients to minimize the risk of recurrence of abscess or anal fistula formation.

Key words: Anorectal abscess, Anal canal, Recurrence, Risk factors

Linyuan Lu, Yun Zhu, Qiong Sun, Qingjun Dong. Prognostic factors of recurrence or anal fistula formation following the drainage of anorectal abscess[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(05): 487-491.

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URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2021.05.007

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References 21

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变量	总数 303	复发/肛瘘组（n=120）	治愈组（n=183）	检验值	P值
性别				6.134	0.013
男	250	91	159
女	53	29	24
年龄（岁）				2.181	0.140
＜40	166	72	94
≥40	137	48	89
嗜烟				0.803	0.370
是	25	12	13
否	278	108	170
嗜酒				0.214	0.643
是	16	6	10
否	287	114	173
肥胖				93.794	＜0.001
是	64	59	5
否	239	61	178
糖尿病				0.638	0.424
有	71	31	40
无	232	89	143
解剖学分类				0.199	0.995
肛周皮下	149	60	89
坐骨直肠窝	113	44	69
括约肌间	35	14	21
肛提肌上	6	2	4
脓肿范围				0.193	0.660
1个象限	167	68	99
≥2个象限	136	52	84
术前抗生素应用				0.169	0.681
有	95	36	59
无	208	84	124
马蹄形脓肿				21.181	＜0.001
是	91	54	37
否	212	66	146
发病时间（天）
＜7	173	71	102	0.348	0.555
≥7	130	49	81

变量	总数 303	复发/肛瘘组（n=120）	治愈组（n=183）	检验值	P值
性别				6.134	0.013
男	250	91	159
女	53	29	24
年龄（岁）				2.181	0.140
＜40	166	72	94
≥40	137	48	89
嗜烟				0.803	0.370
是	25	12	13
否	278	108	170
嗜酒				0.214	0.643
是	16	6	10
否	287	114	173
肥胖				93.794	＜0.001
是	64	59	5
否	239	61	178
糖尿病				0.638	0.424
有	71	31	40
无	232	89	143
解剖学分类				0.199	0.995
肛周皮下	149	60	89
坐骨直肠窝	113	44	69
括约肌间	35	14	21
肛提肌上	6	2	4
脓肿范围				0.193	0.660
1个象限	167	68	99
≥2个象限	136	52	84
术前抗生素应用				0.169	0.681
有	95	36	59
无	208	84	124
马蹄形脓肿				21.181	＜0.001
是	91	54	37
否	212	66	146
发病时间（天）
＜7	173	71	102	0.348	0.555
≥7	130	49	81

变量	Hazard ratio	95% CI	P值
女性	1.336	0.958~2.678	0.015
年龄＜40岁	1.512	0.823~2.781	0.151
嗜烟	1.324	0.728~2.406	0.358
嗜酒	0.946	0.416~2.151	0.894
肥胖	5.295	3.647~7.686	＜0.001
马蹄形脓肿	2.756	1.913~3.971	＜0.001
脓肿范围≥2个象限	1.018	0.706~1.467	0.926
发病时间＜7天	1.041	0.968~1.412	0.846
术前抗生素应用	0.935	0.631~1.385	0.738
糖尿病	1.052	0.688~1.609	0.815
解剖学分类
肛周皮下	1.0
坐骨直肠窝	1.033	0.700~1.524	0.871
括约肌间	0.770	0.405~1.466	0.427
肛提肌上	0.674	0.165~2.760	0.583

变量	Hazard ratio	95% CI	P值
女性	1.336	0.958~2.678	0.015
年龄＜40岁	1.512	0.823~2.781	0.151
嗜烟	1.324	0.728~2.406	0.358
嗜酒	0.946	0.416~2.151	0.894
肥胖	5.295	3.647~7.686	＜0.001
马蹄形脓肿	2.756	1.913~3.971	＜0.001
脓肿范围≥2个象限	1.018	0.706~1.467	0.926
发病时间＜7天	1.041	0.968~1.412	0.846
术前抗生素应用	0.935	0.631~1.385	0.738
糖尿病	1.052	0.688~1.609	0.815
解剖学分类
肛周皮下	1.0
坐骨直肠窝	1.033	0.700~1.524	0.871
括约肌间	0.770	0.405~1.466	0.427
肛提肌上	0.674	0.165~2.760	0.583

变量	Hazard ratio	95% CI	P值
女性	1.759	1.122~2.759	0.014
肥胖	4.886	3.336~7.158	＜0.001
马蹄形脓肿	2.431	1.669~3.542	＜0.001

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