Effect of diabetes mellitus on short-term prognosis of 227 pyogenic liver abscess patients after hospitalization

Abstract

Background: 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. However, the effect of DM on the short-term prognosis of PLA patients after hospitalization remained unknown. Methods: Two hundred twenty-seven PLA patients who received treatment at the First 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. Results: The 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). Conclusions: In PLA patients, DM aggravated short-term mortality and blood glucose levels should be well controlled.

Maximal diameter of liver abscess independently predicts prolonged hospitalization and poor prognosis in patients with pyogenic liver abscess

“…The mortality rate in the early 1900s was 60–80%; however, recent studies have reported a mortality rate of 2–13% [ 31 ]. According to previous studies, comorbid diseases and risk factors such as underlying DM, malignancy, or liver cirrhosis have been associated with poor prognosis [ 7 , 32 ]. In the present study, in-hospital mortality was as low as 2%, and upon reviewing the cause of death, most patients died of sepsis.…”

Risk Factors for 28-Day Mortality in a Surgical ICU: A Retrospective Analysis of 347 Cases

“… 4 Comorbidities such as hypertension, diabetes mellitus, cardiovascular and respiratory diseases are often associated with poor outcomes in critically ill patients. 5 , 6 Due to improvement in the management of these conditions, however, several recent studies have indicated that serious comorbidities are not independent risk factors for mortality in the ICU. 7 , 8 The elderly patients are expected to consume more ICU resources in the future.…”

Stenotrophomonas maltophilia: An uncommon cause of liver abscess

“…An extensive search of the PUBMED from 1966 for “liver abscess/hepatic abscess and” AND “ Pseudodomonas maltophilia / Xanthomonas maltophilia / Stenotrophomonas maltophilia”, revealed very few number of such cases [ [6] , [7] , [8] , [9] , [10] , [11] ]. Of these, three cases were in immunocompromised patients comprising of diabetes, human immunodeficiency virus (HIV) infected, and a neonate each [ [6] , [7] , [8] ], while, two cases occurred in apparently immune-competent persons [ 9 , 10 ]. One case was described as a part of microbiological profile of pyogenic liver abscesses in patients <70 years age [ 11 ].…”

“…Both aerobes and facultative anaerobes like Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp, Staphylococcus spp , Enterococcus spp , Citrobacter spp , Streptococcus spp as well as obligate anaerobes like Bacillus fragilis , Bacteroides species, Fusobacterium , and Clostridia have been implicated [ [2] , [3] , [4] , [5] ]. Stenotrophomonas maltophilia, an environmental Gram-negative bacterium with low virulence, heralded widely as an emerging global opportunistic pathogen, has only rarely been isolated from PLA cases before [ [6] , [7] , [8] , [9] , [10] , [11] ].…”