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Clinical comparison of febrile and afebrile patients with pyogenic liver abscess: A two-centre retrospective study
Jie Yu1, Jun Ma1, Hairong Wang2
1Department of Emergency, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital, Jiangyue Road, Minhang District, Shanghai, China.
Background:
: Limited research has been conducted on afebrile pyogenic liver abscess (PLA). This poses a challenge in rapid diagnosis and early tailored care to physicians. In his study, we aimed to compare the clinical characteristics of afebrile and febrile patients with PLA.
Methods:
: We retrospectively analyzed the data of patients with PLA who were admitted to the emergency departments of two university hospitals between January 2014 and March 2020. Patients were classified into afebrile and febrile groups by using body temperature higher than 38°C as the reference standard. The demographic, clinical, and laboratory characteristics of both groups were compared. The primary outcome was all-cause in-hospital mortality and length of hospital stay. Multivariate analysis was performed to define factors associated with afebrile PLA.
Results:
: Of the 239 patients included in this study, 51 patients (21.3%) were afebrile and 188 patients (78.7%) were febrile. There were no differences between the abscess characteristics, laboratory manifestations, and disease severity of both groups; however, age and Charlson score differed between the groups (P = 0.009 and P = 0.011). The all-cause in-hospital mortality rate was much higher in the afebrile PLA group than in the febrile PLA group (9.8% vs. 2.1%, P = 0.011). Regarding the length of stay, no significant differences were noted in the febrile PLA group compared with the afebrile PLA group (18.5% vs 17.3%, P = 0.514). In multivariate analyses, only age greater than 65 years was significantly associated with afebrile PLA.
Conclusions:
: Afebrile patients with PLA tend to be older, have higher Charlson scores, and in-hospital mortality rate than those with febrile patients. PLA patients older than 65 years are more likely to present without fever (<38°C) at the time of the emergency visit.
Insights
Afebrile pyogenic liver abscess (PLA) patients are older, have higher mortality rates, and similar hospital stays compared to febrile PLA patients. Advanced age is a key factor for afebrile PLA presentation.
Area of Science:
- Hepatology
- Infectious Diseases
- Internal Medicine
Background:
- Limited research exists on afebrile pyogenic liver abscess (PLA), complicating diagnosis and treatment.
- Afebrile PLA presents diagnostic challenges for physicians, necessitating a comparison of clinical characteristics.
Purpose of the Study:
- To compare the clinical characteristics of afebrile and febrile patients diagnosed with pyogenic liver abscess (PLA).
- To identify factors associated with afebrile PLA presentation.
Main Methods:
- Retrospective analysis of 239 PLA patients from two university hospitals (January 2014 - March 2020).
- Patients categorized as afebrile or febrile (temperature >38°C).
- Comparison of demographic, clinical, and laboratory data; primary outcomes: in-hospital mortality and length of stay; multivariate analysis for afebrile PLA predictors.
Main Results:
- Of 239 patients, 51 (21.3%) were afebrile. Afebrile PLA patients were older with higher Charlson scores (P=0.009, P=0.011).
- In-hospital mortality was significantly higher in the afebrile group (9.8% vs. 2.1%, P=0.011).
- Length of stay did not differ significantly between groups (18.5% vs. 17.3%, P=0.514). Age >65 years was the only significant predictor of afebrile PLA.
Conclusions:
- Afebrile PLA patients are typically older, possess higher Charlson scores, and experience greater in-hospital mortality than febrile PLA patients.
- Patients over 65 years are more prone to presenting with afebrile pyogenic liver abscess.
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