Korean J Gastroenterol.  2015 Jul;66(1):27-32. 10.4166/kjg.2015.66.1.27.

Clinical Characteristics and Outcomes of Pyogenic Liver Abscess in Elderly Korean Patients

• Wi JW
• Cho EA
• Jun CH
• Park SY
• Park CH
• Joo YE
• Kim HS
• Choi SK
• Rew JS
• Jung SI

• KMID: 2373308
• DOI: http://doi.org/10.4166/kjg.2015.66.1.27

Abstract

BACKGROUND/AIMS
Incidence of pyogenic liver abscess (PLA) has been increasing worldwide, especially in the elderly population. Therefore, the aim of this study is to elucidate the clinical features and outcomes of PLA in elderly patients.
METHODS
A total of 602 patients diagnosed with PLA from January 2003 to January 2013 were analyzed retrospectively. The patients were divided according to two age groups; > or =65 years (n=296) and <65 years (n=306).
RESULTS
The mean age was 73.59+/-5.98 (range, 65-93) years in the elderly group. Significantly higher incidence of females (52.4% vs. 29.1%, p<0.001), hepatobiliary disease (41.2% vs. 24.8%, p<0.001), hepatobiliary procedure (29.4% vs. 13.7%, p<0.001), underlying malignancy (18.2% vs. 4.6%, p<0.001), culture positivity of resistant organism (20.6% vs. 14.4%, p=0.047), occurrence of complication (19.6% vs. 12.8%, p=0.026), and higher white blood cell (13.44+/-6.56 vs. 12.26+/-5.89, p=0.021), but lower rates of right lobe abscess (67.2% vs. 80.4%, p<0.001), fever (68.6% vs. 79.3%, p=0.003), and lower CRP (16.79+/-9.67 vs. 18.80+/-9.86, p=0.012) was observed in elderly PLA patients, compared to younger patients. Regarding complications, elderly patients had higher incidence of septic shock (8.1% vs. 2.3%, p=0.001) and cardiovascular disease (2% vs. 0%, p=0.014).
CONCLUSIONS
More atypical presentations and complications tend to occur in elderly PLA patients compared with younger patients. Clinicians should be aware of these age-related differences in PLA and devise management strategies accordingly.

Keyword

Pyogenic liver abscess; Aged; Elderly; Prognosis

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Anti-Bacterial Agents/therapeutic use
Cardiovascular Diseases/epidemiology/etiology
Child
Drug Resistance, Bacterial
Escherichia coli/isolation & purification
Female
Humans
Incidence
Klebsiella pneumoniae/isolation & purification
Leukocyte Count
Liver Abscess, Pyogenic/*drug therapy/epidemiology/microbiology/*pathology
Male
Middle Aged
Prognosis
Republic of Korea/epidemiology
Retrospective Studies
Sex Factors
Shock, Septic/epidemiology/etiology
Young Adult
Anti-Bacterial Agents

Reference

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