Abstract
BackgroundPyogenic liver abscess (PLA) is an inflammatory disease with increasing incidence. When it occurs with diabetes mellitus (DM), the risk of recurrence and mortality may increase. However, the effect of DM on the short-term prognosis of PLA patients after hospitalization remained unknown.MethodsTwo hundred twenty-seven PLA patients who received treatment at the First Affiliated Hospital of Xi’an Jiaotong University from January 2011 to January 2018 were retrospectively enrolled. They were divided into two groups as the DM group (n = 61) and the Non-DM group (n = 166). In the DM group, HbA1C level < 7% was considered to be good-control of glycaemia (n = 23). The clinical characteristics and overall short-term survival were analyzed.ResultsThe proportion of PLA patients with DM was 26.87%. In the DM group, there was a higher incidence of hypertension and Candida spp. infection. Conservative administration and percutaneous drainage were mainly used in patients with good- (60.87%) and poor-control (60.53%) of glycaemia, respectively. During follow-up, 24 (10.57%) died due to uncontrolled systemic infections and other serious complications. Compared with PLA patients without DM, patients in the DM group had significantly increased 6-month mortality rate after discharge (Log-Rank test, P = 0.021). Poor-control of glycaemia did not reduce the six-month survival, while the recurrence rate of PLA within 3 months showed an almost 3-fold increase (13.16% vs. 4.35%). Further multivariate analyses found that DM was the only independent risk factor for the PLA six-month survival (odds ratio [OR]: 3.019, 95% confidence interval [CI]: 1.138–8.010, P = 0.026). However, the blood glucose level had no significant effect on the short-term survival of PLA patients with DM (Log-Rank test, P = 0.218).ConclusionsIn PLA patients, DM aggravated short-term mortality and blood glucose levels should be well controlled.
Highlights
Pyogenic liver abscess (PLA) is an inflammatory disease with increasing incidence
We conducted a retrospective study on PLA patients with or without diabetes mellitus (DM), and with good or poor control of blood glucose level, comparing their clinical characteristics and shortterm survivals, which might help to improve the diagnosis and prognosis of PLA patients with DM and provide clues of the effect of glycaemic control
Demographic and clinical characteristics A total of 227 patients with PLA were enrolled in this retrospective study
Summary
Pyogenic liver abscess (PLA) is an inflammatory disease with increasing incidence. When it occurs with diabetes mellitus (DM), the risk of recurrence and mortality may increase. Pyogenic liver abscess (PLA), as a serious infectious disease occurs in the liver parenchyma, has shown a trend of increasing incidence and high mortality recently [1]. Research has rarely been published about the effect of blood glycaemic control on these aspects of PLA patients with DM. We conducted a retrospective study on PLA patients with or without DM, and with good or poor control of blood glucose level, comparing their clinical characteristics and shortterm survivals, which might help to improve the diagnosis and prognosis of PLA patients with DM and provide clues of the effect of glycaemic control
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