title: Predictors of Mortality in Korean Patients with Pyogenic Liver Abscess: A Single Center, Retrospective Study.
abstract: OBJECTIVE
  The mortality rate of pyogenic liver abscess (PLA) has decreased dramatically, but it remains a potentially life threatening disease. Most cases are cryptogenic or occur in elderly men with underlying biliary tract disease. Although several studies have addressed the characteristics and etiology of PLA, research on factors affecting PLA-associated mortality is lacking. This study intended to identify the clinical and radiological features, pathogens, complications, and predictors of mortality in Korean PLA patients.
  
  
  METHODS
  The medical records of 231 PLA patients diagnosed at Yeungnam University Medical Center between January 2010 and January 2014 were analyzed. A diagnosis of PLA was made based on imaging studies and blood and abscess cultures. The clinical, radiological, and laboratory findings of patients were analyzed.
  
  
  RESULTS
  The mean patient age was 64.0±12.9 years and the male to female ratio was 1.5:1. Klebsiella pneumoniae was the predominant organism isolated from hepatic abscesses (69.9%) and blood (74.2%). The most common complication was pleural effusion (35.8%) and most common co-infection was cholangitis (8.2%). The overa ll mortality rate of PLA was 6.9% (16/231), and was significantly higher in patients with a history of liver abscess (OR 5.970, 95% CI 1.207-29.529; p=0.028), bilirubinemia (>2 mg/dL) (OR 9.541, 95% CI 2.382-38.216; p=0.001), thrombocytopenia (< 140×10(3)/L) (OR 4.396, 95% CI 1.130-17.106; p=0.033), or anemia (< 12 g/dL) (OR 13.277, 95% CI 1.476-119.423; p=0.021).
  
  
  CONCLUSIONS
  The prognosis of PLA appears to be dependent on underlying pathologies and severity of condition. More aggressive treatment should be considered if a poor prognosis is expected.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Sohn
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Kook Hyun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
mesh_terms: D000368:Aged; D002761:Cholangitis / Q000175:diagnosis; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008100:Liver Abscess / Q000453:epidemiology; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010996:Pleural Effusion / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Klebsiella pneumoniae; Pyogenic liver abscess; Risk factors