Risk factors and prognostic analysis of bacterial liver abscess complicated with myocardial injury
10.3760/cma.j.cn431274-20240813-01243
- VernacularTitle:细菌性肝脓肿合并心肌损伤的危险因素及预后分析
- Author:
Lan WU
1
;
Hongli XIAO
1
;
Guoxing WANG
1
Author Information
1. 首都医科大学附属北京友谊医院急诊科，北京 100050
- Publication Type:Journal Article
- Keywords:
Liver abscess;
Myocardial injury;
Ventricular function, left
- From:
Journal of Chinese Physician
2025;27(8):1222-1227
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors and prognosis of pyogenic liver abscess (PLA) complicated with myocardial injury.Methods:A retrospective selection was made of 108 PLA patients treated in Beijing Friendship Hospital from January 2016 to June 2022 as the research subjects. Patients were divided into the myocardial injury group and non-myocardial injury group according to the occurrence of myocardial injury. Baseline characteristics, laboratory test data, imaging and etiological examination results, echocardiographic indicators, and prognosis were compared between the two groups. A logistic regression model was used to identify the risk factors for PLA complicated with myocardial injury.Results:Among the 108 PLA patients, 24 cases (22.2%) were complicated with myocardial injury. The age of the myocardial injury group was (71±13)years, which was significantly higher than that of the non-myocardial injury group [(59±14)years, P<0.05]. The levels of neutrophil ratio, C-reactive protein (CRP), procalcitonin (PCT), aspartate transaminase (AST), and D-dimer in the myocardial injury group were significantly higher than those in the non-myocardial injury group, while the levels of platelet count (PLT) and albumin (ALB) were significantly lower, with statistically significant differences (all P<0.05). In terms of blood culture, the positive detection rate in the myocardial injury group was as high as 54.2%(13/24), among which the detection rate of Klebsiella pneumoniae was 41.7%(10/24); the positive rate of blood culture in the non-myocardial injury group was only 17.9%(15/84), and the detection rate of Klebsiella pneumoniae was 14.3%(12/84), with statistically significant differences (all P<0.05). The left ventricular ejection fraction in the myocardial injury group was lower than that in the non-myocardial injury group, and the brain natriuretic peptide (BNP) level, the incidence of left ventricular diastolic dysfunction, the proportion of transfer to emergency intensive care unit (EICU), shock, and death were significantly higher than those in the non-myocardial injury group (all P<0.05). Logistic regression analysis showed that age was an independent risk factor for myocardial injury in PLA patients ( P<0.05), and for each 1-year increase in age, the risk of myocardial injury increased by 11.9%. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of age for myocardial injury, with an area under the curve (AUC) of 0.729( P<0.05), and the cut-off value calculated by Youden index was 64.5 years. Conclusions:Age is an independent risk factor for myocardial injury in PLA patients. PLA patients complicated with myocardial injury have poor cardiac function, higher incidence of transfer to EICU, shock, and death, and poor prognosis.
