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PurposeThe purpose of this study was to evaluate the predictive value of a 'Modified Karnofsky Scoring System' on outcomes and provide real-world data regarding the UK practice of biliary interventions.Materials and methodsA prospective multi-centred cohort study was performed. The pre-procedure modified Karnofsky score, the incidence of sepsis, complications, biochemical improvement and mortality were recorded out to 30 days post procedure.ResultsA total of 292 patients (248 with malignant lesions) were suitable for inclusion in the study. The overall 7 and 30 day mortality was 3.1% and 16.1%, respectively. The 30 day sepsis rate was 10.3%. In the modified Karnofsky 'high risk' group the 7 day mortality was 9.7% versus 0% for the 'low risk' group (p = 0.002), whereas the 30 day mortality was 28.8% versus 13.3% (p = 0.003). The incidence of sepsis at 30 days was 19% in the high risk group versus 3.3% at the low risk group (p = 0.001) CONCLUSION: Percutaneous biliary interventions in the UK are safe and effective. Scoring systems such as the Karnofsky or the modified Karnofsky score hold promise in allowing us to identify high risk groups that will need more careful consideration and enhanced patient informed consent but further research with larger studies is warranted in order to identify their true impact on patient selection and outcomes post biliary interventions.

Original publication

DOI

10.1007/s00270-021-02888-0

Type

Journal article

Journal

Cardiovascular and interventional radiology

Publication Date

10/2021

Volume

44

Pages

1625 - 1632

Addresses

Vascular and Interventional Radiology Department, Guy's and St Thomas' Hospital, NHS Foundation Trust, London, UK.

Keywords

Humans, Cholestasis, Treatment Outcome, Drainage, Biliary Tract Surgical Procedures, Cohort Studies, Prospective Studies