Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 12375,
    "title": "Abscess Size and Depth on Ultrasound and Association with Treatment Failure without Drainage",
    "subtitle": null,
    "abstract": "Introduction:\n Skin and soft tissue infections (SSTI) occur along a continuum from cellulitis to abscess. Point-of-care ultrasound (POCUS) is effective in differentiating between these two diagnoses and guiding acute management decisions. Smaller and more superficial abscesses may not require a drainage procedure for cure. The goal of this study was to evaluate the optimal abscess size and depth cut-off for determining when a drainage procedure is necessary.\nMethods:\n We conducted a retrospective study of adult patients with a SSTI who had POCUS performed. Patients were identified through an ultrasound database. We reviewed examinations for the presence, size, and depth of abscess. Medical records were reviewed to determine acute ED management and assess outcomes. The primary outcome evaluated the optimal abscess size and depth when a patient could be safely discharged without a drainage procedure. We defined a treatment failure as a return visit within seven days requiring admission, change in antibiotics, or drainage procedure.\nResults:\n A total of 162 patients had an abscess confirmed on POCUS and were discharged from the ED without a drainage procedure. The optimal cut-off to predict treatment failure by receiver operating curve analysis was 1.3 centimeters (cm) in longest dimension with a sensitivity of 85% and specificity of 37% (area under the curve [AUC] 0.60, 95% confidence interval [CI], 0.44-0.76), and 0.4cm in depth with a sensitivity of 85% and specificity of 68% (AUC 0.83, 95% CI, 0.74-93).\nConclusion:\n This retrospective data suggests that abscesses greater than 0.4 cm in depth from the skin surface may require a drainage procedure. Those less than 0.4 cm in depth may not require a drainage procedure and may be safely treated with antibiotics alone. Further prospective data is needed to validate these findings and to assess for an optimal size cut-off when a patient with a skin abscess may be discharged without a drainage procedure.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Abscess, ultrasound, size, depth, outome, management"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9c65q0vp",
    "frozenauthors": [
        {
            "first_name": "Frances",
            "middle_name": "M.",
            "last_name": "Russell",
            "name_suffix": "",
            "institution": "Indiana University, Department of Emergency Medicine, Indianapolis, Indiana",
            "department": "None"
        },
        {
            "first_name": "Matt",
            "middle_name": "",
            "last_name": "Rutz",
            "name_suffix": "",
            "institution": "Indiana University, Department of Emergency Medicine, Indianapolis, Indiana",
            "department": "None"
        },
        {
            "first_name": "L. Ken",
            "middle_name": "",
            "last_name": "Rood",
            "name_suffix": "",
            "institution": "Indiana University, Department of Emergency Medicine, Indianapolis, Indiana",
            "department": "None"
        },
        {
            "first_name": "Justin",
            "middle_name": "",
            "last_name": "McGee",
            "name_suffix": "",
            "institution": "Indiana University, Department of Emergency Medicine, Indianapolis, Indiana",
            "department": "None"
        },
        {
            "first_name": "Elisa",
            "middle_name": "J.",
            "last_name": "Sarmiento",
            "name_suffix": "",
            "institution": "Indiana University, Department of Emergency Medicine, Indianapolis, Indiana",
            "department": "None"
        }
    ],
    "date_submitted": "2018-12-06T21:00:26Z",
    "date_accepted": "2018-12-06T21:00:26Z",
    "date_published": "2020-02-26T23:34:18Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12375/galley/6587/download/"
        }
    ]
}