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Predictors of Mortality in Korean Patients with Pyogenic Liver Abscess: A Single Center, Retrospective Study
Se Hoon Sohn1, Kook Hyun Kim1, Jae Hyun Park1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
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 overa ll 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)/L) (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.
Insights
Pyogenic liver abscess (PLA) mortality is linked to prior abscess history, high bilirubin, and low platelet or red blood cell counts. Early identification of these risk factors can guide aggressive treatment for better patient outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Internal Medicine
Background:
- Pyogenic liver abscess (PLA) mortality has decreased but remains significant.
- PLA commonly affects elderly men with biliary tract disease.
- Limited research exists on factors predicting PLA-associated mortality.
Purpose of the Study:
- To identify clinical and radiological features of PLA.
- To determine common pathogens and complications in PLA.
- To identify predictors of mortality in Korean PLA patients.
Main Methods:
- Retrospective analysis of 231 PLA patients (Jan 2010-Jan 2014).
- Diagnosis confirmed by imaging and microbial cultures.
- Clinical, radiological, and laboratory data were analyzed.
Main Results:
- Klebsiella pneumoniae was the predominant pathogen.
- Common complications included pleural effusion and cholangitis.
- Mortality rate was 6.9%, with higher risk in patients with prior PLA, bilirubinemia, thrombocytopenia, or anemia.
Conclusions:
- PLA prognosis depends on underlying conditions and disease severity.
- Aggressive treatment is recommended for patients with poor prognostic indicators.