Abstract
Background: To date, no comprehensive epidemiological study exists on pyogenic liver abscess (PLA) risk in patients with newly diagnosed type 2 diabetes mellitus (T2DM) worldwide.Methods: We conducted a retrospective cohort study by using data from Taiwan National Health Insurance Research Database (NHIRD) to examine the association between newly diagnosed T2DM and PLA. The T2DM cohort included patients newly diagnosed as having T2DM (ICD-9-CM:250) from 2000 to 2009, with follow-up until December 31, 2011. The comparison cohort was then recruited through 1:4 random frequency matching with the T2DM cohort. Finally, the adjusted hazard ratios for PLA were compared between the T2DM and comparison cohorts, which included 44,728 patients with T2DM and 178,912 patients without DM respectively.Results: In T2DM cohort, 166 patients were diagnosed as having PLA (incidence rate = 5.87 per 10,000 person-years) and in comparison cohort, 238 patients were diagnosed as having PLA (incidence rate = 2.06 per 10,000 person-years). The T2DM cohort exhibited higher PLA risk than did the comparison cohort (hazard ratio = 2.83, 95% confidence interval = 2.32–3.46). Furthermore, the adjusted hazard ratio for PLA risk in T2DM cohort was the highest in those who were younger, man and with duration of DM <2 years. In the T2DM cohort, the most common PLA causative agent was Klebsiella pneumonia (KP). In addition, PLA risk was high in T2DM patients with gallstone and cholecystitis. Compared with comparison cohort, patients with T2DM prescribed acarbose has a lower PLA risk, however glyburide significantly increased PLA risk in T2DM cohort.Conclusion: In patients with newly diagnosed T2DM, PLA risk was high and acarbose might reduce PLA risk.
Highlights
Pyogenic liver abscess (PLA) is a serious infectious and lifethreatening disease with a low but gradually increasing annual incidence rate
To date, no comprehensive epidemiological study exists on pyogenic liver abscess (PLA) risk in patients with newly diagnosed type 2 diabetes mellitus (T2DM) worldwide
In T2DM cohort, 166 patients were diagnosed as having PLA and in comparison cohort, 238 patients were diagnosed as having PLA
Summary
Pyogenic liver abscess (PLA) is a serious infectious and lifethreatening disease with a low but gradually increasing annual incidence rate. The incidence rate was only 1.0 per 100,000 person-years from 1997 to 2002 in Denmark [1] and 2.3 per 100,000 person-years from 1999 to 2003 in Canada [2]. PLA incidence rate is much higher in Taiwan. A nationwide analysis from the National Health Insurance Research Database (NHIRD) data from 2000 through 2011 demonstrated that the annual incidence of PLA for all ages groups increased gradually from 10.83 per 100,000 person-years in 2000 to 15.45 per 100,000 person-years in 2011 [3]. No comprehensive epidemiological study exists on pyogenic liver abscess (PLA) risk in patients with newly diagnosed type 2 diabetes mellitus (T2DM) worldwide
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