1.Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
Chih Weim HSIANG ; Chang Hsien LIU ; Hsiu Lung FAN ; Kai Hsiung KO ; Chih Yung YU ; Hong Hau WANG ; Wen I LIAO ; Hsian He HSU ; Wei Chou CHANG
Yonsei Medical Journal 2015;56(2):519-528
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.
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
2.Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
Chih Weim HSIANG ; Chang Hsien LIU ; Hsiu Lung FAN ; Kai Hsiung KO ; Chih Yung YU ; Hong Hau WANG ; Wen I LIAO ; Hsian He HSU ; Wei Chou CHANG
Yonsei Medical Journal 2015;56(2):519-528
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.
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