Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis
Pyogenic liver abscess (PLA) is a common cause of hepatobiliary sepsis. Klebsiella pneumoniae (KP) is the most common organism causing PLA. Evidence is scarce on the demographics, radiological findings, and outcomes of KPPLA versus non-KPPLA (N-KPPLA). PubMed, Embase, The Cochrane Library, and Scopu...
| Main Authors: | , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
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2023
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| Online Access: | https://hdl.handle.net/10356/165206 |
| _version_ | 1826117774732165120 |
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| author | Chan, Kai Siang Chia, Christopher Tze Wei Shelat, Vishal G. |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Chan, Kai Siang Chia, Christopher Tze Wei Shelat, Vishal G. |
| author_sort | Chan, Kai Siang |
| collection | NTU |
| description | Pyogenic liver abscess (PLA) is a common cause of hepatobiliary sepsis. Klebsiella pneumoniae (KP) is the most common organism causing PLA. Evidence is scarce on the demographics, radiological findings, and outcomes of KPPLA versus non-KPPLA (N-KPPLA). PubMed, Embase, The Cochrane Library, and Scopus were systematically searched until 14 May 2022 for studies comparing KPPLA and N-KPPLA. Exclusion criteria were single-arm studies. Primary outcomes were mortality (30-day/in-hospital) and metastatic complications. There were 16 studies, including 5127 patients (KPPLA n = 3305, N-KPPLA n = 1822). Patients with KPPLA were younger (mean difference: −2.04 years, p = 0.02). History of hepatobiliary disease (Odds ratio (OR) 0.30, 95% CI: 0.20, 0.46) and malignancy (OR 0.26, 95% CI: 0.16, 0.42) were less common in KPPLA. KPPLA was associated with lower incidence of multiple abscesses (OR 0.52, 95% CI: 0.35, 0.76, p < 0.001) and bilobar abscesses (OR 0.60, 95% CI: 0.49, 0.74, p < 0.001). KPPLA has higher overall metastatic complications (KPPLA 9.7% vs. N-KPPLA 4.8%, OR 3.16, 95% CI: 2.00, 4.99, p < 0.001), but lower mortality (KPPLA 3.9% vs. N-KPPLA 7.6%, OR 0.51, 95% CI: 0.34, 0.78, p < 0.001). Trial sequential analysis showed conclusive evidence that KPPLA has lower mortality than N-KPPLA. In conclusion, KPPLA has lower mortality than N-KPPLA. |
| first_indexed | 2024-10-01T04:32:50Z |
| format | Journal Article |
| id | ntu-10356/165206 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T04:32:50Z |
| publishDate | 2023 |
| record_format | dspace |
| spelling | ntu-10356/1652062023-03-26T15:41:42Z Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis Chan, Kai Siang Chia, Christopher Tze Wei Shelat, Vishal G. Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS Science::Medicine Escherichia Coli Hepatic Abscess Pyogenic liver abscess (PLA) is a common cause of hepatobiliary sepsis. Klebsiella pneumoniae (KP) is the most common organism causing PLA. Evidence is scarce on the demographics, radiological findings, and outcomes of KPPLA versus non-KPPLA (N-KPPLA). PubMed, Embase, The Cochrane Library, and Scopus were systematically searched until 14 May 2022 for studies comparing KPPLA and N-KPPLA. Exclusion criteria were single-arm studies. Primary outcomes were mortality (30-day/in-hospital) and metastatic complications. There were 16 studies, including 5127 patients (KPPLA n = 3305, N-KPPLA n = 1822). Patients with KPPLA were younger (mean difference: −2.04 years, p = 0.02). History of hepatobiliary disease (Odds ratio (OR) 0.30, 95% CI: 0.20, 0.46) and malignancy (OR 0.26, 95% CI: 0.16, 0.42) were less common in KPPLA. KPPLA was associated with lower incidence of multiple abscesses (OR 0.52, 95% CI: 0.35, 0.76, p < 0.001) and bilobar abscesses (OR 0.60, 95% CI: 0.49, 0.74, p < 0.001). KPPLA has higher overall metastatic complications (KPPLA 9.7% vs. N-KPPLA 4.8%, OR 3.16, 95% CI: 2.00, 4.99, p < 0.001), but lower mortality (KPPLA 3.9% vs. N-KPPLA 7.6%, OR 0.51, 95% CI: 0.34, 0.78, p < 0.001). Trial sequential analysis showed conclusive evidence that KPPLA has lower mortality than N-KPPLA. In conclusion, KPPLA has lower mortality than N-KPPLA. Published version 2023-03-20T05:35:15Z 2023-03-20T05:35:15Z 2022 Journal Article Chan, K. S., Chia, C. T. W. & Shelat, V. G. (2022). Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis. Pathogens, 11(9), 976-. https://dx.doi.org/10.3390/pathogens11090976 2076-0817 https://hdl.handle.net/10356/165206 10.3390/pathogens11090976 36145408 2-s2.0-85138561465 9 11 976 en Pathogens © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). application/pdf |
| spellingShingle | Science::Medicine Escherichia Coli Hepatic Abscess Chan, Kai Siang Chia, Christopher Tze Wei Shelat, Vishal G. Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title | Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title_full | Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title_fullStr | Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title_full_unstemmed | Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title_short | Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. Non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis |
| title_sort | demographics radiological findings and clinical outcomes of klebsiella pneumonia vs non klebsiella pneumoniae pyogenic liver abscess a systematic review and meta analysis with trial sequential analysis |
| topic | Science::Medicine Escherichia Coli Hepatic Abscess |
| url | https://hdl.handle.net/10356/165206 |
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