From: Initial presentations and final outcomes of primary pyogenic liver abscess: a cross-sectional study
Survivor | Mortality | Total | Univariate logistic regression analysis | ||||
---|---|---|---|---|---|---|---|
N = 128 (%) | N = 6 (%) | N = 134(%) | p value | Odds ratio | 95% confidence interval | P-value | |
Demographic data | |||||||
Gender, male (%) | 34 (26.6%) | 5 (83.3%) | 39 (29.1%) | <0.001 | 1.879 | 2.284–11.130 | 0.006 |
Age, mean ± SD*1 (years) | 53.6 ± 18.9 | 67.5 ± 7.4 | 59.4 ± 16.3 | 0.705 | |||
Length of hospitalization, mean ± SD (days) | 10.2 ± 8.3 | 17.2 ± 6.3 | 14.2 ± 7.3 | 0.612 | |||
Underlying diseases & co-morbidity | |||||||
Category C of disease severity on admission a*2, mean ± SD | 15 (11.7%) | 2 (33.3%) | 17 (10.4%) | 0.025 | |||
Coexisting diseases, no. (%) | |||||||
Diabetes mellitus | 84 (65.6%) | 2 (33.3%) | 86 (64.2%) | 0.055 | |||
Biliary disorders*3 | 44 (34.4%) | 4 (66. 7%) | 48 (35.8%) | 0.055 | |||
Alcoholism | 45 (35.2%) | 2 (33.3%) | 47 (35.1%) | 1.000 | |||
Liver cirrhosis | 46 (35.9%) | 3 (50%) | 49 (36.6%) | 0.530 | |||
Malignancy*4 | 37 (28.9%) | 4 (66. 7%) | 41 (30.6%) | <0.001 | 2.067 | 1.174–13.130 | 0.004 |
Uremia | 49 (38.3%) | 3 (50%) | 52 (37.6%) | 0.750 | |||
Delay issue | |||||||
Patient delay (days), mean (range) | 10 (1–124) | 9 (1–91) | 0.569 | ||||
Total delay (days), mean (range) | 19 (1–124) | 17 (1–91) | 0.459 | ||||
Symptoms and signs on admission, no. (%) | |||||||
Fever/chills | 118 (92.2%) | 4 (66.7%) | 122 (91.0%) | 0.069 | |||
Abdominal pain | 117 (91.4%) | 5 (83.3%) | 122 (91.0%) | 0.256 | |||
Anorexia | 12 (9.4%) | 2 (33.3%) | 14 (10.5%) | 0.056 | |||
Malaise | 115 (89.9%) | 5 (83.3%) | 120 (89.6%) | 0.322 | |||
Nausea/emesis | 114 (89.1%) | 4 (66.7%) | 118 (12.7%) | 0.057 | |||
Respiratory distress*5 | 15 (11.7%) | 3 (50%) | 18 (13.4%) | 0.007 | 1.667 | 1.164–14.210 | 0.006 |
Signs on admission, no. (%) | |||||||
Body temperature > 38.3°C | 111 (86.7%) | 6 (100%) | 117 (87.3%) | 0.358 | |||
Blood pressure < 90/60 mmHg | 38 (29.7%) | 2 (33.3%) | 40 (29.8%) | 0.001 | 2.167 | 2.104–13.150 | 0.003 |
Right upper quadrant tenderness | 109 (85.2%) | 3 (50%) | 112 (83.6%) | 0.701 | |||
Jaundice | 20 (15.6%) | 5 (83.3%) | 25 (18.7%) | <0.001 | 1.900 | 1.246–3.297 | 0.008 |
Murphy's sign*6 | 21 (16.4%) | 1 (16.7%) | 22 (16.4%) | 0.869 | |||
Hepatomegaly | 22 (17.2%) | 0 (0%) | 22 (16.4%) | 0.125 | |||
Disturbance of consciousness | 23 (17.8%) | 1 (16.7%) | 24 (17.9%) | 0.980 | |||
Ascites | 24 (18.8%) | 1 (16.7%) | 25 (18.7%) | 1.000 | |||
Source of infection, no. (%) | |||||||
Biliary origin*7 | 32 (25%) | 4 (66.7%) | 36 (26.9%) | 0.069 | |||
Cryptogenic origin | 33 (25.8%) | 1 (16.7%) | 34 (25.4%) | 0.729 | |||
Sonographic findings at first examination, no (%) | |||||||
Negative findings and equivocal | 5 (83.3%) | 1 (16.7%) | 6 (4.5%) | 0.077 | |||
Single abscesss (77%) | 101 (98.1%) | 2 (1.9%) | 103 (77%) | 0.063 | |||
Right lobe (72.3%) | 95 (97.9%) | 2 (2.1%) | 97 (72.3%) | 0.071 | |||
Multiple abscesses (23%) | 30 (96.8%) | 1 (3.2%) | 31(23%) | 1.000 | |||
Gas formation | 27 (96.4%) | 1 (3.6%) | 28 (20.9%) | 1.000 | |||
Difficulty at initial aspiration | 8 (88.9%) | 1 (11.1%) | 9 (6.7%) | 0.161 | |||
Microbiology | 0.028 | ||||||
Klebsiella pneumonia | 93 (97.9%) | 2 (2.1%) | 95 (70.8%) | ||||
Non- Klebsiella GNB | 28 (90.3%) | 3 (9.7% ) | 31 (23.1%) | ||||
Aerobic GPC | 4 (80%) | 1 (20%) | 5 (3.7%) | ||||
Anaerobes | 1 (100%) | 0 | 1 (0.4%) | ||||
Mixed infection | 2 (100%) | 0 | 2 (1.4%) | ||||
Treatment | |||||||
Doctor delay of effective antibiotics therapy (days), mean (range) | 8 (0–33) | 4 (0–37) | 0.101 | ||||
Prolonged doctor delay of effective antibiotics therapy (>8 days) | 78 (61.5%) | 2 (33.3%) | 0.118 | ||||
Delay of aspiration/drainage (days), mean (range) | 9 (0–33) | 7 (0–27) | 0.201 | ||||
Prolonged delay of aspiration/drainage therapy (>9 days) | 78 (61.5%) | 1 (16.7%) | 0.008 | ||||
Complications, no. (%) | |||||||
Rupture of liver abscess | 0 (0%) | 2 (33.3%) | 2 (1.5%) | <0.001 | 5.167 | 2.194–23.150 | 0.003 |
Endophthalmitis, related to PPLA | 7 (5.6%) | 2 (33.3%) | 9 (6.7%) | 0.003 | 2.167 | 1.234–13.140 | 0.005 |
Multiple organ failure, related to PPLA | 4 (3.1%) | 6 (100%) | 10 (7.5%) | <0.001 | 3.067 | 1.184–15.150 | 0.001 |