title: The association of haemoglobin A₁C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus.
abstract: OBJECTIVE
  To compare the characteristics of Klebsiella pneumoniae liver abscesses (KPLA) in diabetic patients with different levels of glycaemic control.
  
  
  METHODS
  The institutional review board approved this retrospective study. A total of 221 patients with KPLA were included. Clinical features of KPLA were compared. We divided the 120 diabetic patients with KPLA into three subgroups based on haemoglobin A1C (HbA1C) concentration (good, HbA1C ≤ 7.0 %; suboptimal, 7.0 % < HbA1C ≤ 9.0 %; poor, HbA1C > 9.0 %). In this study, we used a semiautomated quantitative method to assess the gas and total abscess volumes in KPLA. Statistical analysis was performed with the chi-squared test and one-way analysis of variance.
  
  
  RESULTS
  The mortality rate did not significantly differ between the nondiabetic and diabetic groups. However, patients with poor glycaemic control had significantly more complications and therefore a longer hospital stay (P < 0.05). In our study, CT and quantitative analyses found that patients in the group with poor glycaemic control had a significantly higher incidence of gas formation and hepatic venous thrombophlebitis and a higher gas-to-abscess volume ratio than patients with suboptimal and good glycaemic control (P < 0.05).
  
  
  CONCLUSIONS
  Diabetic patients with a high HbA1C concentration (>9.0 %) have an association with hepatic venous thrombophlebitis, gas formation and metastatic infection complications associated with KPLA.
  
  
  CONCLUSIONS
  • Poorly controlled diabetes is associated with complications in Klebsiella pneumoniae liver abscesses. • Hepatic venous thrombosis and gas are important signs of metastatic infection. • Hepatic venous thrombophlebitis is associated with 72.7 % of metastatic infections.
authors.affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Hong-Hau
authors.initials: HH
authors.lastname: Wang
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Tsai
authors.forename: Chih-Yung
authors.initials: CY
authors.lastname: Yu
authors.forename: Hsian-He
authors.initials: HH
authors.lastname: Hsu
authors.forename: Chang-Hsien
authors.initials: CH
authors.lastname: Liu
authors.forename: Jung-Chung
authors.initials: JC
authors.lastname: Lin
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Wei-Tung
authors.initials: WT
authors.lastname: Cheng
authors.forename: Ho-Jui
authors.initials: HJ
authors.lastname: Tung
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Chen
authors.forename: Wei-Chou
authors.initials: WC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications / Q000097:blood / Q000000981:diagnostic imaging* / Q000382:microbiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008100:Liver Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013924:Thrombophlebitis / Q000097:blood / Q000209:etiology / Q000382:microbiology; D014057:Tomography, X-Ray Computed
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human