Tsai Ming-Shian, Lee Hui-Ming, Hsin Ming-Che, Lin Cheng-Li, Hsu Chung-Y, Liu Yen-Tze, Kao Chia-Hung
From the Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung (M-ST, H-ML, M-CH), School of Medicine, China Medical University, Taichung (C-LL), Management Office for Health Data, China Medical University Hospital (C-LL), Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung (C-YH, C-HK), Family Medicine Department, Changhua Christian Hospital, Changhua City (Y-TL), Master of Public Health Degree Program, National Taiwan University, Taipei City (Y-TL), and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Medicine (Baltimore). 2015 Dec;94(49):e2210. doi: 10.1097/MD.0000000000002210.
Whether patients with diverticular diseases exhibit a higher risk of developing pyogenic liver abscess (PLA) remains inconclusive.From the inpatient claims in Taiwan's National Health Insurance Research Database, we identified 54,147 patients diagnosed with diverticulosis in the 1998 to 2010 period and 216,588 controls without the disorder. The 2 cohorts were matched by age, sex, and admission year, and were followed up until the end of 2010 to estimate the risk of PLA.Overall, the incidence of PLA was 2.44-fold higher in the diverticular-disease group than in the controls (11.5 vs 4.65 per 10,000 person-year). The adjusted hazard ratio (aHR) of PLA was 2.11 (95% confidence interval [CI], 1.81-2.44) for the diverticular-disease group, according to a multivariate Cox proportional hazards regression model. The age-specific data showed that the aHR for the diverticular-disease group, compared with the controls, was the highest inpatients younger than 50 years old (aHR, 4.03; 95% CI, 2.77-5.85). Further analysis showed that the diverticular-disease group exhibited an elevated risk of PLA regardless of whether patients had diverticulitis.The patients with diverticular diseases exhibited a higher risk of PLA.
憩室病患者发生化脓性肝脓肿（PLA）的风险是否更高尚无定论。通过台湾国民健康保险研究数据库中的住院理赔记录，我们确定了1998年至2010年期间被诊断为憩室病的54147例患者以及216588例无此病的对照者。这两组按年龄、性别和入院年份进行匹配，并随访至2010年底以评估发生PLA的风险。总体而言，憩室病组PLA的发病率比对照组高2.44倍（每10000人年分别为11.5例和4.65例）。根据多变量Cox比例风险回归模型，憩室病组PLA的调整后风险比（aHR）为2.11（95%置信区间[CI]，1.81 - 2.44）。特定年龄的数据显示，与对照组相比，憩室病组在50岁以下的住院患者中aHR最高（aHR，4.03；95%CI，2.77 - 5.85）。进一步分析表明，无论患者是否患有憩室炎，憩室病组发生PLA的风险均升高。憩室病患者发生PLA的风险更高。
