title: Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score > or =15.
abstract: BACKGROUND
  Most liver abscesses resolve after antimicrobial therapy or percutaneous tube drainage (PD). The aim of this study was to evaluate the results of hepatic resection (HR) for patients with pyogenic liver abscesses and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score > or =15.
  
  
  METHODS
  We compared the clinical outcomes of 81 patients with APACHE II scores > or =15 undergoing PD and/or HR.
  
  
  RESULTS
  The failure rate (3 of 65) and double-treatment rate (32 of 65) in the PD group were significantly higher than in the HR group (3 of 35 vs 0 of 35; P = .0002). The mortality rate in the PD group was significantly higher than the other 2 groups (14 of 46 vs 2 of 19 and 1 of 16; P = .038). The length of hospital stay was significantly shorter and antibiotic use less in the HR group than in the PD group (P < .05).
  
  
  CONCLUSIONS
  Aggressive HR for patients with liver abscesses and APACHE II scores > or =15 produced better clinical outcomes.
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Huan-Fa
authors: HF
authors: Hsieh
authors: Teng-Wei
authors: TW
authors: Chen
authors: Chih-Yung
authors: CY
authors: Yu
authors: Ning-Chi
authors: NC
authors: Wang
authors: Heng-Cheng
authors: HC
authors: Chu
authors: Ming-Liang
authors: ML
authors: Shih
authors: Jyh-Cherng
authors: JC
authors: Yu
authors: Chung-Bao
authors: CB
authors: Hsieh
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome