title: Clinical features and computed tomography characteristics of non-Klebsiella pneumoniae liver abscesses in elderly (>65 years) and nonelderly patients.
abstract: OBJECTIVE
  To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients.
  
  
  METHODS
  Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age ≥65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA.
  
  
  RESULTS
  Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA.
  
  
  CONCLUSIONS
  In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Chih-Weim
authors: CW
authors: Hsiang
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Chang-Hsien
authors: CH
authors: Liu
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Hsiu-Lung
authors: HL
authors: Fan
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Kai-Hsiung
authors: KH
authors: Ko
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Chih-Yung
authors: CY
authors: Yu
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Hong-Hau
authors: HH
authors: Wang
authors: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Wen-I
authors: WI
authors: Liao
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Hsian-He
authors: HH
authors: Hsu
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. weichou.chang@gmail.com.
authors: Wei-Chou
authors: WC
authors: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae; D007902:Length of Stay; D008100:Liver Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D016015:Logistic Models; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Klebsiella pneumoniae; Liver abscess; age; computed tomography