Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses
Introduction: Poor liquefaction of pyogenic liver abscesses, which makes drainage impossible at the time of diagnosis, is not infrequent. The impact of poor liquefaction and subsequent drainage failure on clinical outcomes is unknown. Methods: We conducted a retrospective study with all patients dia...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118222001098 |
| _version_ | 1797936409759186944 |
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| author | Eliel Nham Jeong Hyun Lee Kyungmin Huh Jae-Hoon Ko Sun Young Cho Cheol-In Kang Doo Ryeon Chung Hee Jae Huh Nam Yong Lee Kyong Ran Peck |
| author_facet | Eliel Nham Jeong Hyun Lee Kyungmin Huh Jae-Hoon Ko Sun Young Cho Cheol-In Kang Doo Ryeon Chung Hee Jae Huh Nam Yong Lee Kyong Ran Peck |
| author_sort | Eliel Nham |
| collection | DOAJ |
| description | Introduction: Poor liquefaction of pyogenic liver abscesses, which makes drainage impossible at the time of diagnosis, is not infrequent. The impact of poor liquefaction and subsequent drainage failure on clinical outcomes is unknown. Methods: We conducted a retrospective study with all patients diagnosed with liver abscesses from July 2017 through June 2020. Late drainage (LD) was defined as drainage performed ≥48 h after diagnosis due to poor liquefaction. Logistic regression was performed to identify the factors associated with late or non-drainage (LD/ND). The Cox proportional hazard model was used to identify the variables related to abscess recurrence by 90 days after diagnosis. Results: A total of 153 patients were included. Thirty (19.6%) patients underwent LD and 54 (35.3%) did not undergo drainage. Other than non-cystic appearance, LD/ND was associated with smaller size (adjusted odds ratio [aOR] 0.85, 95% confidence interval [CI] 0.73–0.98, p = 0.031) and culture-negativity (aOR 2.69, 95% CI 1.14–6.67, p = 0.027). Current hepatopancreaticobiliary malignancy was the only significant predictor of 90-day recurrence. Neither LD/ND (OR, 0.56; 95% CI, 0.13–2.41; p = 0.426) nor LD (OR, 1.26; 95% CI, 0.23–5.55; p = 0.719) was associated with recurrence by 90 days. The incidence of late complications was reduced by drainage, without a reduction in the duration of hospitalization. Conclusion: Several clinical features were associated with undrainable liver abscesses. Neither LD/ND nor ND had an adverse impact on clinical outcomes. |
| first_indexed | 2024-04-10T18:30:22Z |
| format | Article |
| id | doaj.art-df2ab5e971f84df5b8298f241e86d229 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-04-10T18:30:22Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-df2ab5e971f84df5b8298f241e86d2292023-02-02T04:47:47ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822023-02-015616474Predictive and prognostic factors associated with unliquefied pyogenic liver abscessesEliel Nham0Jeong Hyun Lee1Kyungmin Huh2Jae-Hoon Ko3Sun Young Cho4Cheol-In Kang5Doo Ryeon Chung6Hee Jae Huh7Nam Yong Lee8Kyong Ran Peck9Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDepartment of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea; Corresponding author. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, (06351) 81 Irwon-ro, Gangnam-gu, Seoul, South Korea. Fax: +82 2 3410 0064.Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaDivision of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South KoreaIntroduction: Poor liquefaction of pyogenic liver abscesses, which makes drainage impossible at the time of diagnosis, is not infrequent. The impact of poor liquefaction and subsequent drainage failure on clinical outcomes is unknown. Methods: We conducted a retrospective study with all patients diagnosed with liver abscesses from July 2017 through June 2020. Late drainage (LD) was defined as drainage performed ≥48 h after diagnosis due to poor liquefaction. Logistic regression was performed to identify the factors associated with late or non-drainage (LD/ND). The Cox proportional hazard model was used to identify the variables related to abscess recurrence by 90 days after diagnosis. Results: A total of 153 patients were included. Thirty (19.6%) patients underwent LD and 54 (35.3%) did not undergo drainage. Other than non-cystic appearance, LD/ND was associated with smaller size (adjusted odds ratio [aOR] 0.85, 95% confidence interval [CI] 0.73–0.98, p = 0.031) and culture-negativity (aOR 2.69, 95% CI 1.14–6.67, p = 0.027). Current hepatopancreaticobiliary malignancy was the only significant predictor of 90-day recurrence. Neither LD/ND (OR, 0.56; 95% CI, 0.13–2.41; p = 0.426) nor LD (OR, 1.26; 95% CI, 0.23–5.55; p = 0.719) was associated with recurrence by 90 days. The incidence of late complications was reduced by drainage, without a reduction in the duration of hospitalization. Conclusion: Several clinical features were associated with undrainable liver abscesses. Neither LD/ND nor ND had an adverse impact on clinical outcomes.http://www.sciencedirect.com/science/article/pii/S1684118222001098DrainageLate drainageLiver abscessUndrainableUnliquefied |
| spellingShingle | Eliel Nham Jeong Hyun Lee Kyungmin Huh Jae-Hoon Ko Sun Young Cho Cheol-In Kang Doo Ryeon Chung Hee Jae Huh Nam Yong Lee Kyong Ran Peck Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses Journal of Microbiology, Immunology and Infection Drainage Late drainage Liver abscess Undrainable Unliquefied |
| title | Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| title_full | Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| title_fullStr | Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| title_full_unstemmed | Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| title_short | Predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| title_sort | predictive and prognostic factors associated with unliquefied pyogenic liver abscesses |
| topic | Drainage Late drainage Liver abscess Undrainable Unliquefied |
| url | http://www.sciencedirect.com/science/article/pii/S1684118222001098 |
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