title: APACHE II score and primary liver cancer history had risk of hospital mortality in patients with pyogenic liver abscess.
abstract: BACKGROUND
  The Acute Physiology and Chronic Health Evaluation II classification system has been extensively used for predicting the patient mortality in various diseases. However, its utilisation on the pyogenic liver abscess has not yet been well studied.
  
  
  OBJECTIVE
  The purpose of this study was to validate this system on this high death rate disease.
  
  
  METHODS
  A retrospective study was conducted to assess 314 patients with pyogenic liver abscesses admitted to tertiary medical centre in past 12 years.
  
  
  METHODS
  The outcome measurement was the in-hospital mortality. A multiple logistic regression model was used to assess the association between mortality and Acute Physiology and Chronic Health Evaluation II score while controlling for the potential confounding factors.
  
  
  RESULTS
  The overall in-hospital mortality was 8.3%. The mean Acute Physiology and Chronic Health Evaluation II score of the expired patients was higher (P<0.0001). The mortality rate increased rapidly when Acute Physiology and Chronic Health Evaluation II score >or=15. After controlling for the potential confounding factors, patient with high admission Acute Physiology and Chronic Health Evaluation II score >or=15 had a higher chance of in-hospital mortality (P<0.01). In addition, the primary liver cancer history is also a risk factor (P=0.03).
  
  
  CONCLUSIONS
  The Acute Physiology and Chronic Health Evaluation II score and the primary liver cancer history predict the in-hospital mortality of the pyogenic liver abscess patient.
authors.affiliation: Department of Surgery, Division of General Surgery, National Defence Medical Center, Tri-Service General Hospital, 325, Sec. 2, Cheng-Kung Road, 114 Taipei, Taiwan.
authors.forename: C-B
authors.initials: CB
authors.lastname: Hsieh
authors.forename: C
authors.initials: C
authors.lastname: Tzao
authors.forename: C-Y
authors.initials: CY
authors.lastname: Yu
authors.forename: C-J
authors.initials: CJ
authors.lastname: Chen
authors.forename: W-K
authors.initials: WK
authors.lastname: Chang
authors.forename: C-H
authors.initials: CH
authors.lastname: Chu
authors.forename: S-J
authors.initials: SJ
authors.lastname: Chou
authors.forename: H-J
authors.initials: HJ
authors.lastname: Tung
authors.forename: J-C
authors.initials: JC
authors.lastname: Yu
mesh_terms: D018806:APACHE; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000150:complications* / Q000382:microbiology / Q000401:mortality* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications* / Q000382:microbiology / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate