Korean J Gastroenterol.  2016 May;67(5):238-244. 10.4166/kjg.2016.67.5.238.

Predictors of Mortality in Korean Patients with Pyogenic Liver Abscess: A Single Center, Retrospective Study

Affiliations
  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. kimkh@yu.ac.kr

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.

Keyword

Pyogenic liver abscess; Risk factors; Klebsiella pneumoniae

MeSH Terms

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

Cited by  2 articles

간농양 파열로 인한 복막염의 비수술적 치료 증례
Hee Jun Myung, Soo Hyung Ryu, Chung Hao Liu, Jung Hoon Yoo, Seo Hyun Kim, Seung Hyuk Kim, Won Eui Yoon, Tae Young Park, Jeong Seop Moon
Korean J Gastroenterol. 2021;77(4):190-193.    doi: 10.4166/kjg.2021.005.

Needs of Treatment Strategies for Decreasing Mortality of Pyogenic Liver Abscess Patients
Jeong Han Kim
Korean J Gastroenterol. 2016;67(5):231-232.    doi: 10.4166/kjg.2016.67.5.231.


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