Management of liver abscesses - A retrospective analysis at the University Hospital Leipzig as well as SHI billing data
- Conditions
- Amoebic liver abscessAbscess of liverK75.0A06.4
- Registration Number
- DRKS00021793
- Lead Sponsor
- Medizinische Klinik II - Bereich Gastroenterologie Interdisziplinäre Zentrale Ultraschalleinheit Universitätsklinikum Leipzig AöR
- Brief Summary
Results: 221 patients (median age 63 years, 63% male) with PLA were included. Biliary malignancies (33%), cholelithiasis (23%), and ischemic bile duct disease (16%) were frequent causes of PLA. Comorbidities included malignancies (40%) and diabetes mellitus (35%). Abdominal ultrasound was the preferred initial imaging modality (58%). Microbiological cultures from abscess punctate (available from 74% of patients) were positive in 88% and blood cultures (from 78% of patients) in 54% of cases; cultures identified Enterobacterales (58%), enterococci (42%), and streptococci (18%) as most frequent pathogens. 97% of patients were treated with antibiotics and 75% of patients underwent an invasive treatment procedure. 30-day-mortality was almost identical in patients with and without underlying malignancy (14.6% vs. 14.4%, p=0.96), whereas one-year outcome differed significantly (58.4% vs. 29.6%, p<0.001). Positive blood cultures (OR 4.78, 95% CI 1.39 to 22.5, p=0.023) and detection of Enterobacterales (OR 3.55, 95% CI 1.40 to 9.97, p=0.010) were associated with increased 30-day-mortality. Conclusions: PLA represent a severe complication of biliary disorders. Abdominal ultrasound and blood cultures are important diagnostic instruments and guide empiric anti-infective therapy and interventional treatment, which is deployed in the majority of patients.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 227
Diagnosis of a liver abscess
Period: January 1, 2013 to December 31, 2019 (this also corresponds to the available data set for work package II), Primary treatment in the clinics for internal medicine and surgery as well as the associated intensive care units and the emergency room at the UKL, Age = 18 years, Patients or their legal representatives who have consented to the processing of their data for study purposes upon admission to the UKL (signature)
Patients with ICD-10 coding of a liver abscess, but clinically proven alternative diagnosis (e.g. echinococcosis)
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Prevalence / incidence, genesis and outcome of liver abscesses at the UKL and in the SHI billing data
- Secondary Outcome Measures
Name Time Method Symptoms, travel history, comorbidities, medication, initial imaging, ascites, liver puncture, abscess morphology, localization, laboratory values, ITS stay, pathogen detection, performing amoeba serology, blood culture decrease, positivity of blood cultures, primary therapy, period from diagnosis to primary therapy, change of therapy