Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
10.3349/ymj.2015.56.2.519
- Author:
Chih Weim HSIANG
1
;
Chang Hsien LIU
;
Hsiu Lung FAN
;
Kai Hsiung KO
;
Chih Yung YU
;
Hong Hau WANG
;
Wen I LIAO
;
Hsian He HSU
;
Wei Chou CHANG
Author Information
1. Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. weichou.chang@gmail.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Liver abscess;
Klebsiella pneumoniae;
computed tomography;
age
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Bacterial Infections/*complications/*radiography;
Female;
Humans;
Klebsiella Infections/microbiology;
Klebsiella pneumoniae;
Length of Stay;
Liver Abscess/complications/microbiology/*radiography;
Logistic Models;
Male;
Microscopy;
Middle Aged;
Multivariate Analysis;
ROC Curve;
Retrospective Studies;
Tomography, X-Ray Computed/*methods
- From:Yonsei Medical Journal
2015;56(2):519-528
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
