Predictors of Mortality in Korean Patients with Pyogenic Liver Abscess: A Single Center, Retrospective Study.
10.4166/kjg.2016.67.5.238
- Author:
Se Hoon SOHN
1
;
Kook Hyun KIM
;
Jae Hyun PARK
;
Tae Nyeun KIM
Author Information
1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. kimkh@yu.ac.kr
- Publication Type:Original Article
- Keywords:
Pyogenic liver abscess;
Risk factors;
Klebsiella pneumoniae
- MeSH:
Abscess;
Academic Medical Centers;
Aged;
Anemia;
Biliary Tract Diseases;
Cholangitis;
Coinfection;
Diagnosis;
Female;
Humans;
Hyperbilirubinemia;
Klebsiella pneumoniae;
Liver Abscess;
Liver Abscess, Pyogenic*;
Male;
Medical Records;
Mortality*;
Pathology;
Pleural Effusion;
Prognosis;
Retrospective Studies*;
Risk Factors;
Thrombocytopenia
- From:The Korean Journal of Gastroenterology
2016;67(5):238-244
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The mortality rate of pyogenic liver abscess (PLA) has decreased dramatically, but it remains a potentially life threatening disease. Most cases are cryptogenic or occur in elderly men with underlying biliary tract disease. Although several studies have addressed the characteristics and etiology of PLA, research on factors affecting PLA-associated mortality is lacking. This study intended to identify the clinical and radiological features, pathogens, complications, and predictors of mortality in Korean PLA patients. METHODS: The medical records of 231 PLA patients diagnosed at Yeungnam University Medical Center between January 2010 and January 2014 were analyzed. A diagnosis of PLA was made based on imaging studies and blood and abscess cultures. The clinical, radiological, and laboratory findings of patients were analyzed. RESULTS: The mean patient age was 64.0±12.9 years and the male to female ratio was 1.5:1. Klebsiella pneumoniae was the predominant organism isolated from hepatic abscesses (69.9%) and blood (74.2%). The most common complication was pleural effusion (35.8%) and most common co-infection was cholangitis (8.2%). The overall mortality rate of PLA was 6.9% (16/231), and was significantly higher in patients with a history of liver abscess (OR 5.970, 95% CI 1.207-29.529; p=0.028), bilirubinemia (>2 mg/dL) (OR 9.541, 95% CI 2.382-38.216; p=0.001), thrombocytopenia (<140×10(3)/µL) (OR 4.396, 95% CI 1.130-17.106; p=0.033), or anemia (<12 g/dL) (OR 13.277, 95% CI 1.476-119.423; p=0.021). CONCLUSIONS: The prognosis of PLA appears to be dependent on underlying pathologies and severity of condition. More aggressive treatment should be considered if a poor prognosis is expected.
