A 10-Year Retrospective Analysis of Clinical Profiles, Laboratory Characteristics and Management of Pyogenic Liver Abscesses in a Chinese Hospital.
- Author:
Xiaojuan ZHU
1
;
Shaohui WANG
;
Ravi JACOB
;
Zhining FAN
;
Faming ZHANG
;
Guozhong JI
Author Information
1. Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China. jgz@njmu.edu.cn, firsyzhang@njmu.edu.cn
- Publication Type:Original Article
- Keywords:
Asian Continental Ancestry Group;
Pyogenic liver abscess;
Clinical audit;
Early diagnosis;
Treatment outcome
- MeSH:
Alanine Transaminase;
Asian Continental Ancestry Group;
Biliary Tract Diseases;
Clinical Audit;
Comorbidity;
Diabetes Mellitus;
Early Diagnosis;
Fibrinogen;
Hospital Mortality;
Hospitalization;
Humans;
Length of Stay;
Leukocytosis;
Liver Abscess, Pyogenic;
Retrospective Studies;
Shock;
Tertiary Care Centers;
Thrombocytopenia;
Treatment Outcome
- From:Gut and Liver
2011;5(2):221-227
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Pyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The aim of this study was to collect demographic data and clinical, laboratory and microbiological characteristics of PLA patients treated between 2000 and 2010. We also aimed to collect information regarding our management experience of these cases. METHODS: As a retrospective review, 47 patients with PLA in a tertiary referral center were examined to determine their demographic characteristics, clinical features, and laboratory, imaging, and microbiologic findings as well as the treatment outcome. RESULTS: Cryptogenic PLA was the most frequently identified type of PLA, while benign biliary tract disease was the most frequently identifiable cause of PLA (18/47 patients; 38.3%). Leukocytosis and elevated alanine transaminase were common laboratory findings and were observed in 35 (74.5%) and 22 (46.8%) patients, respectively. Increased fibrinogen was also detected in 11 of 15 investigated cases (73.3%). Notably, infection-induced thrombocytopenia occurred in 8 patients (17%). Diabetes mellitus was associated with the occurrence of infection induced shock when compared to the non-diabetic group (p<0.05). Patients with two or more comorbid diseases had longer hospitalizations when compared to patients with one comorbid disease or those without comorbidities (p<0.001). The number of days needed to establish diagnosis was correlated with the length of hospitalization (p<0.001). The overall hospital mortality rate was 2.1% (1/47). CONCLUSIONS: Characteristics of PLA patients from the past 10 years are presented. The number of days needed to establish a PLA diagnosis was correlated with the length of the hospital stay. The hospital stay of PLA patients can be further improved by early diagnosis and effective treatments during the early stages of PLA progression.
