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Pyogenic liver abscesses: mortality-related factors

José Juan Ruiz-Hernández1, Magdalena León-Mazorra, Alicia Conde-Martel

  • 1Department of Internal Medicine, University Hospital of Gran Canaria Dr Negrín, Las Palmas, Gran Canaria, Spain.

European Journal of Gastroenterology & Hepatology
|September 18, 2007
PubMed
Abstract

Insights

Pyogenic liver abscess (PLA) is a serious condition with a high mortality rate. Sepsis and/or septic shock are identified as the primary independent risk factor for mortality in PLA patients.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Critical Care Medicine

Background:

  • Pyogenic liver abscess (PLA) is a rare but life-threatening infection.
  • Factors contributing to mortality in PLA patients require further investigation.

Purpose of the Study:

  • To analyze the clinical characteristics of patients hospitalized with PLA.
  • To identify factors associated with complications and mortality in PLA.

Main Methods:

  • Retrospective review of medical records for 84 patients hospitalized with PLA between 1992 and 2005.
  • Data collected included medical history, clinical presentation, laboratory values, imaging, microbiology, treatment, complications, and mortality.
  • Statistical analysis was performed to identify risk factors for complications and mortality.

Main Results:

  • The most common bacterial isolates were Streptococcus spp. (40.5%) and Escherichia coli (27.4%).
  • Complications occurred in 60.7% of cases, with right pleural effusion being the most frequent.
  • The overall mortality rate was 19%, significantly associated with age, coronary heart disease, absence of fever, sepsis/septic shock, elevated bilirubin, biliary/cryptogenetic origin, E. coli/Candida infection, and pneumonia.

Conclusions:

  • Pyogenic liver abscess carries a substantial mortality risk.
  • Sepsis and/or septic shock emerged as the principal independent risk factor for mortality in PLA patients.

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