Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2024 Nov 4;14(1):26718. doi: 10.1038/s41598-024-77799-4.
Thromboembolism, a serious complication in patients with liver abscesses, can lead to organ deterioration if left untreated. However, factors associated with thromboembolism in these patients remain poorly understood. We aimed to identify the factors associated with liver abscess complications, with a focus on thromboembolism and metastatic infection. Data from 325 patients diagnosed with liver abscesses between March 2019 and June 2023 were retrospectively collected. Baseline clinical and laboratory variables associated with thromboembolic events and metastatic infections were analyzed using logistic regression. A nomogram for predicting thromboembolism was constructed using significant predictors. Among the 325 patients, the median age was 68.0 years, and included 129 women. Fifty patients experienced thromboembolic events and 44 had metastatic infections. Significant predictors for thromboembolic events included white blood cell (WBC) ≥ 20,000/µL (odds ratio [OR] 3.401, p = 0.002), platelet count < 100,000/µL (OR 3.291, p = 0.004), and abscess septation (OR 2.704, p = 0.007). Age ≥ 65 years (OR 0.457, p = 0.040), WBC ≥ 20,000/µL (OR 3.340, p = 0.005), and abscess septation (OR 2.909, p = 0.008) were identified as factors associated with metastatic infections. A nomogram was constructed to predict thromboembolism using the following four variables: WBC ≥ 20,000/µL platelet count < 100,000/µL, albumin < 2.8 g/dL, and abscess septation, and demonstrated an AUROC of 0.755. Our study is the first to develop a reliable nomogram for thromboembolism prediction, utilizing easily accessible clinical parameters. This innovative model enables clinicians to efficiently identify high-risk patients, facilitating the implementation of additional studies to mitigate the risk of overlooked thromboembolic events in these at-risk individuals.
血栓栓塞是肝脓肿患者的一种严重并发症，如果不加以治疗，可能导致器官恶化。然而，这些患者发生血栓栓塞的相关因素仍了解甚少。我们旨在确定与肝脓肿并发症相关的因素，重点关注血栓栓塞和转移性感染。回顾性收集了 2019 年 3 月至 2023 年 6 月期间诊断为肝脓肿的 325 名患者的数据。使用逻辑回归分析与血栓栓塞事件和转移性感染相关的基线临床和实验室变量。使用有意义的预测因子构建预测血栓栓塞的列线图。在 325 名患者中，中位年龄为 68.0 岁，包括 129 名女性。50 名患者发生血栓栓塞事件，44 名患者发生转移性感染。血栓栓塞事件的显著预测因子包括白细胞 (WBC) ≥ 20,000/μL (比值比 [OR] 3.401，p = 0.002)、血小板计数 < 100,000/μL (OR 3.291，p = 0.004) 和脓肿分隔 (OR 2.704，p = 0.007)。年龄≥65 岁 (OR 0.457，p = 0.040)、WBC ≥ 20,000/μL (OR 3.340，p = 0.005) 和脓肿分隔 (OR 2.909，p = 0.008) 被确定为与转移性感染相关的因素。使用以下四个变量构建了一个预测血栓栓塞的列线图：WBC ≥ 20,000/μL、血小板计数 < 100,000/μL、白蛋白 < 2.8 g/dL 和脓肿分隔，其 AUROC 为 0.755。我们的研究首次开发了一种可靠的血栓栓塞预测列线图，利用易于获取的临床参数。这种创新模型使临床医生能够有效地识别高危患者，从而促进开展更多研究，以减少这些高危个体中被忽视的血栓栓塞事件的风险。
