Clinical characteristics and prognosis factors of bacterial liver abscess patients with and without diabetes mellitus

Abstract

Objective To assess the clinical characteristics and prognostic factors of bacterial liver abscess in patients with or without diabetes mellitus, and to provide clinical guides for the diagnosis and treatment. Methods A total of 208 patients with bacterial liver abscess were enrolled during January 2014 and January 2018 in Zhejiang Provincial People’s Hospital, including 67 patients with diabetes mellitus and 141 patients without diabetes mellitus. Clinical characteristics, laboratory examinntion, imaging findings, etiology results, treatment and prognosis were analyzed. Multiple logistic regression analysis was performed to analyze the prognosis between patients with and without diabetes. Results The majority of patients were male, and the fever was the most common symptom. The incidence of right upper abdominal pain in diabetic group was lower than that in non-diabetic group (32.84% vs 47.5%, χ2=3.999, P<0.05) . Compared with non-diabetic group, the neutrophil percentage and hemoglobin A1c were (84.0±6.8) % and (9.8±2.6) %, which were higher (t=2.263, 13.716, P<0.05) , while the albumin and hemoglobin were lower in diabetic group (t= -2.862, -2.034, P<0.05) . Klebsiella pneumonia was the most common pathogens and the positive ratewashigher in diabetic group (χ2=3.893, P<0.05) . Multivariate logistic regression analysis showed that multiple abscesses (OR=8.761, 95%CI: 1.364-56.259) and abscess size≥10 cm (OR=9.648, 95%CI: 1.496-62.232) were independent risk factors for poor prognosis in diabetic patients. Hypoalbuminemia (OR=2.794, 95%CI: 1.062-7.349) and abscess size≥10 cm (OR=3.777, 95%CI: 1.402-10.178) were independent risk factors for poor prognosis in non-diabetic patients. Conclusions Diabetic patients with liver abscess have atypical clinical characteristics and ware commonly caused by Klebsiella pneumonia. The size and number of abscesses may be associated with its prognosis. Key words: Liver abscess, pyogenic; Diabetes mellitus; Etiology; Risk factor