Ruiz-Hernández José Juan, León-Mazorra Magdalena, Conde-Martel Alicia, Marchena-Gómez Joaquín, Hemmersbach-Miller Marion, Betancor-León Pedro
Department of Internal Medicine, University Hospital of Gran Canaria Dr Negrín, Las Palmas, Gran Canaria, Spain.
Eur J Gastroenterol Hepatol. 2007 Oct;19(10):853-8. doi: 10.1097/MEG.0b013e3282eeb53b.
To analyse the characteristics and mortality-related factors in a series of patients hospitalized for pyogenic liver abscess (PLA).
Pyogenic liver abscesses are infrequent but potentially life threatening. Factors related to mortality have been less studied.
The medical records of 84 patients, 56 men and 28 women, mean age of 64.4 years (SD: 14) who were hospitalized between 1992 and 2005 owing to a PLA were reviewed. The past medical history, clinical signs and symptoms, laboratory values, imaging studies, microbiological features, treatment, complications and mortality were recorded. Factors related to complications and mortality were analysed.
One or more bacteria were isolated in 65 patients (77.4%), being Streptococcus spp. (40.5%), Escherichia coli (27.4%), Klebsiella spp. (14.3%) and anaerobics (17.9%) the most frequent isolates. Complications developed in 60.7% of the cases, the most common one being a right pleural effusion (34.5%). Mortality rate was 19% (95% confidence interval: 10-28%). Mortality was associated with age (P=0.005), a previous history of coronary heart disease (P=0.016), absence of fever (P=0.001), development of sepsis and/or septic shock (P<0.001), raise of bilirubin levels (P=0.004), a biliary (P=0.035), or cryptogenetic origin (P=0.039), infection owing to E. coli (P=0.01) or to Candida (P=0.009) and development of pneumonia (P<0.001). Logistic regression revealed sepsis and/or septic shock as an independent risk factor for mortality.
Mortality associated with PLA is high. The main risk factor for mortality is the development of sepsis and/or septic shock.
分析一系列因化脓性肝脓肿（PLA）住院患者的特征及与死亡率相关的因素。
化脓性肝脓肿虽不常见，但有潜在生命危险。与死亡率相关的因素研究较少。
回顾了1992年至2005年间因PLA住院的84例患者的病历，其中男性56例，女性28例，平均年龄64.4岁（标准差：14）。记录既往病史、临床症状和体征、实验室检查值、影像学检查、微生物学特征、治疗、并发症及死亡率。分析与并发症和死亡率相关的因素。
65例患者（77.4%）分离出一种或多种细菌，最常见的分离菌为链球菌属（40.5%）、大肠杆菌（27.4%）、克雷伯菌属（14.3%）和厌氧菌（17.9%）。60.7%的病例出现并发症，最常见的是右侧胸腔积液（34.5%）。死亡率为19%（95%置信区间：10 - 28%）。死亡率与年龄（P = 0.005）、冠心病既往史（P = 0.016）、无发热（P = 0.001）、发生败血症和/或感染性休克（P < 0.ooo1）、胆红素水平升高（P = 0.004）、胆汁性（P = 0.035）或隐源性病因（P = 0.039）、大肠杆菌（P = 0.01）或念珠菌感染（P = 0.009）及发生肺炎（P < 0.001）有关。逻辑回归显示败血症和/或感染性休克是死亡率的独立危险因素。
PLA相关死亡率较高。死亡率的主要危险因素是败血症和/或感染性休克的发生。
