PDF(Pubmed)
Abstract：
UNASSIGNED: Pyogenic liver abscess (PLA) is a potentially life-threatening intra-abdominal infection. We compared the clinical features, treatments, and prognoses of patients who had Klebsiella pneumonia pyogenic liver abscess (KPPLA) and non-Klebsiella pneumonia pyogenic liver abscess (non-KPPLA).
UNASSIGNED: A retrospective analysis was used to compare the medical records of KPPLA and non-KPPLA patients with positive pus cultures at a single hospital in China from January 2017 to December 2019.
UNASSIGNED: We examined 279 patients with definitively established PLA, 207 (74.2 %) with KPPLA, and 72 with non-KPPLA. The non-KPPLA group had a higher Charlson comorbidity index, longer hospital stay, longer duration of fever, and greater hospital costs. Multivariate analysis showed that alcohol intake (OR: 2.44, P = 0.048), cancer (OR: 4.80, P = 0.001), ICU admission (OR: 10.61, P = 0.026), resolution of fever OR: 1.04, P = 0.020), and a positive blood culture (OR: 2.87, P = 0.029) were independent predictors of primary treatment failure. Percutaneous needle aspiration (PNA) and pigtail catheter drainage (PCD) provided satisfactory outcomes, but PNA led to shorter hospital stays and reduced costs, especially in KPPLA patients whose abscesses were smaller than 10 cm.
UNASSIGNED: KPPLA and non-KPPLA patients had some differences in comorbidities and treatment strategies, and non-KPPLA patients had a significantly worse prognosis.
UNASSIGNED: A retrospective analysis was used to compare the medical records of KPPLA and non-KPPLA patients with positive pus cultures at a single hospital in China from January 2017 to December 2019.
UNASSIGNED: We examined 279 patients with definitively established PLA, 207 (74.2 %) with KPPLA, and 72 with non-KPPLA. The non-KPPLA group had a higher Charlson comorbidity index, longer hospital stay, longer duration of fever, and greater hospital costs. Multivariate analysis showed that alcohol intake (OR: 2.44, P = 0.048), cancer (OR: 4.80, P = 0.001), ICU admission (OR: 10.61, P = 0.026), resolution of fever OR: 1.04, P = 0.020), and a positive blood culture (OR: 2.87, P = 0.029) were independent predictors of primary treatment failure. Percutaneous needle aspiration (PNA) and pigtail catheter drainage (PCD) provided satisfactory outcomes, but PNA led to shorter hospital stays and reduced costs, especially in KPPLA patients whose abscesses were smaller than 10 cm.
UNASSIGNED: KPPLA and non-KPPLA patients had some differences in comorbidities and treatment strategies, and non-KPPLA patients had a significantly worse prognosis.
摘要：
■化脓性肝脓肿（PLA）是一种可能危及生命的腹腔感染。我们比较了临床特征，治疗,肺炎克雷伯菌化脓性肝脓肿（KPPLA）和非肺炎克雷伯菌化脓性肝脓肿（非KPPLA）患者的预后。
■采用回顾性分析比较了2017年1月至2019年12月在中国一家医院脓液培养阳性的KPPLA和非KPPLA患者的病历。
■我们检查了279名明确的PLA患者，207（74.2%）与KPPLA，和72与非KPPLA。非KPPLA组的Charlson合并症指数较高，住院时间更长，发烧持续时间较长，更多的医院费用。多因素分析显示酒精摄入量(OR:2.44,P=0.048),癌症（OR：4.80，P=0.001），ICU入院（OR：10.61，P=0.026），发烧分辨率OR：1.04，P=0.020），血培养阳性(OR:2.87,P=0.029)是主要治疗失败的独立预测因素。经皮针抽吸术（PNA）和猪尾导管引流（PCD）提供了令人满意的结果，但是PNA缩短了住院时间并降低了成本，尤其是在脓肿小于10cm的KPPLA患者中。
■KPPLA和非KPPLA患者在合并症和治疗策略上有一些差异，非KPPLA患者的预后明显较差。
■采用回顾性分析比较了2017年1月至2019年12月在中国一家医院脓液培养阳性的KPPLA和非KPPLA患者的病历。
■我们检查了279名明确的PLA患者，207（74.2%）与KPPLA，和72与非KPPLA。非KPPLA组的Charlson合并症指数较高，住院时间更长，发烧持续时间较长，更多的医院费用。多因素分析显示酒精摄入量(OR:2.44,P=0.048),癌症（OR：4.80，P=0.001），ICU入院（OR：10.61，P=0.026），发烧分辨率OR：1.04，P=0.020），血培养阳性(OR:2.87,P=0.029)是主要治疗失败的独立预测因素。经皮针抽吸术（PNA）和猪尾导管引流（PCD）提供了令人满意的结果，但是PNA缩短了住院时间并降低了成本，尤其是在脓肿小于10cm的KPPLA患者中。
■KPPLA和非KPPLA患者在合并症和治疗策略上有一些差异，非KPPLA患者的预后明显较差。
