Impact of advanced age on inpatients with pyogenic liver abscess in Taiwan: A nationwide claim-based analysis

Abstract

Background Pyogenic liver abscess (PLA) is seen as an endemic disease in population of Taiwan. The impact of advanced age on inpatients with PLA remains unclear. Methods Data was collected and analyzed from claims of discharges by inpatients with PLA, using the National Health Insurance Research Database of 2007. Results A total of 2319 subjects and 2651 related discharges were enrolled, including 939 subjects/1077 discharges ≥65 years and 1380 subjects/1574 discharges <65 years. Subjects ≥65 years had significantly higher ratios of females to males, nephropathy, biliary tract diseases, liver cirrhosis and gastroenterological cancers than those <65 years. Hepatic/intra-hepatic duct cancers accounted for the most comorbid gastroenterological cancers. Discharged of subjects ≥65 years had longer hospital stays, more in-hospital death/critical discharge, and a higher ratio of acute low respiratory conditions (ALRC) and urological infections than those of subjects <65 years ( p < 0.05). The inpatient costs for subjects ≥65 years were significantly higher than those for subjects age<65 years in blood products, hemodialysis and total hospitalization. Co-morbidities, such as nephropathy, biliary tract diseases, liver cirrhosis, gastroenterological cancers, ALRC and urological infections were predictive variables associated with age ≥65 years in patients with PLA, as were being female and in-hospital death/critical discharge. Nephropathy and gastroenterological cancers were predictive variables associated with poor prognosis (in-hospital death/critical discharge) in both PLA patients age < and ≥65 years ( p < 0.05). Diabetes mellitus featured predominantly, but had no impact on distribution and prognosis. Conclusion Advanced age (≥65 years) had an impact on the aforementioned characteristics and predictive variables in inpatients with PLA. Physicians should pay attention and treat aged PLA patients with greater care, especially those cares with comorbid nephropathy or gastroenterological cancers.