School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Ophthalmology. 2012 Nov;119(11):2358-63. doi: 10.1016/j.ophtha.2012.05.022. Epub 2012 Jul 18.
Although endophthalmitis secondary to pyogenic liver abscess (PLA) is becoming a globally emerging infectious disease, population-based investigations evaluating the relationship between PLA and endogenous endophthalmitis remain scarce. This study aimed to investigate the incidence and risk of endogenous endophthalmitis in patients with PLA compared with unaffected individuals by using a nationwide, population-based dataset.
Retrospective, cohort study.
This study used data sourced from Taiwan's National Health Insurance Research Database. In total, 12 727 patients with PLA were included in the study group and 63 635 matched subjects were randomly extracted as a comparison group.
Stratified Cox proportional hazards regressions were performed to assess the effect of PLA on the hazard of developing endogenous endophthalmitis.
The incidence and risk of endogenous endophthalmitis between the study group and comparison group.
Of the total sample, 148 subjects (0.10%) were diagnosed with endophthalmitis during the 1-year follow-up period. Endophthalmitis was found in 106 patients (0.84%) with PLA and 42 comparison patients (0.07%). After adjusting for patient monthly income, geographic location, and urbanization level, those suffering from PLA were found to have a greater likelihood of developing endophthalmitis during the 1-year follow-up period than comparison patients (hazard ratio [HR], 12.83; 95% confidence interval, 8.94-18.41). Stratification did not reveal any large differences in the adjusted HRs for endophthalmitis between PLA patients suffering from diabetes and those in whom diabetes was absent. We further analyzed the etiology of cases with endogenous endophthalmitis in this investigation and found Klebsiella pneumonia to be the causative organism among 75.5% of the cases but only 33.4% of the comparison group.
We found that the incidence and risk of developing endophthalmitis was significantly higher among patients with PLA compared with matched controls irrespective of diabetes status.
尽管化脓性肝脓肿（PLA）继发眼内炎已成为一种全球新兴传染病，但基于人群的研究评估 PLA 与内源性眼内炎之间关系的研究仍然很少。本研究旨在使用全国性的基于人群的数据集，调查 PLA 患者与无 PLA 个体相比内源性眼内炎的发生率和风险。
回顾性队列研究。
本研究使用来自台湾全民健康保险研究数据库的数据。共纳入 12727 例 PLA 患者作为研究组，随机抽取 63635 例匹配对照作为对照组。
采用分层 Cox 比例风险回归评估 PLA 对发生内源性眼内炎的危险比。
研究组和对照组内源性眼内炎的发生率和风险。
在总样本中，148 例（0.10%）患者在 1 年随访期间被诊断为眼内炎。PLA 患者中有 106 例（0.84%）和 42 例对照患者（0.07%）发生眼内炎。调整患者月收入、地理位置和城市化水平后，与对照患者相比，PLA 患者在 1 年随访期间发生眼内炎的可能性更高（风险比[HR]，12.83；95%置信区间，8.94-18.41）。分层分析未发现 PLA 患者合并糖尿病与无糖尿病患者眼内炎的调整 HR 存在显著差异。我们进一步分析了本研究中内源性眼内炎病例的病因，发现肺炎克雷伯菌是 75.5%病例的致病病原体，而仅占对照组的 33.4%。
无论糖尿病状况如何，我们均发现 PLA 患者发生眼内炎的发生率和风险均显著高于匹配对照。
