A retrospective cohort study of epidemiology, clinical features and outcome of liver abscess at Sunpasitthiprasong Hospital Ubonratchathani Province, Northeast Thailand

Abstract

Background and rationale: Liver abscess is a common intra-abdominal infection, accounting for approximately 48% of all intra-abdominal infections². Liver abscesses are found throughout many regions of the world, especially in developing countries. Despite recent improvements in diagnosis and treatment, liver abscess remains an infection with a high mortality rate.

Objectives: study the etiology of liver abscesses, clinical characteristics related to the pathogens, laboratory test results and radiological images related to the pathogens, treatment results and death rates. in adult patients of Sappasitthiprasong Hospital

Materials and methods: This research is a retrospective observational study of patients aged over 15 years who came for treatment of liver abscess between 1 Jan. 2012- 31 Dec. 2018 in Sappasitthiprasong Hospital Ubon Ratchathani Province. The criteria for inclusion in the study were age 15 years and over, being treated in a hospital, and receiving a systematic diagnosis. International Classification of Disease Tenth Revision (ICD-10) diagnostic code of K750, A064 is diagnosed as liver abscess. Criteria for exclusion from the study (exclusion criteria) are incomplete information. Data collection (data collection) The researcher collects data from diagnosed patients. Liver abscess according to the ICD-10 code above by reviewing hospital medical records. and collect data Basic information about the population includes gender, age, occupation, congenital diseases, and risk of disease, symptom information, and detected symptoms. Additional diagnostic tests include pus culture, hemo culture, hematocrit, white blood cell count, Eosinophilic count, platelets count, FBS, BUN, Cr, Liver function test, Chest X-ray, Ultrasound abdomen, CT abdomen, MRI abdomen. , hospital stay information, treatment information and treatment results, diagnosis information according to disease group (ICD 10)

Comparative analysis was performed using chi-square test and Fisher. Study of pathogens causing liver abscess, study of clinical characteristics associated with pathogens, laboratory test results and radiological images associated with pathogens. Diseases, treatment results and death rates in patients

Conclusion: From the study it was found that the cause of liver abscess in patients from this study was most cases were caused by pyogenic liver abscess. No patients with amoebic liver abscess were found. Relate with previous studies which found that the trend of most liver abscesses was caused by pyogenic liver abscess. increased and the trend of amoebic liver abscess decreased. Most of the bacteria are Gram negative bacteria, with the first 3 most common bacteria being B. pseudomallei, followed by K. pneumoniae and E.coli, which is different from the data from studies in Thailand that have passed where K. pneumoniae is found most. The most common symptom was Fever, followed by Abdominal pain/ epigastrium pain and Shaking chill, respectively. The most common physical examination findings were Hepatomegaly and Right knocking pain, followed by Jaudice. The most common related disease was Diabetis mellitus. followed by Hypertension and S/P hepatobiliary Sx. As for extrahepatic infections, the top 3 were pneumonia, skin infection, and arthritis. Most were treated with antibiotics. Percutaneous drainage and surgery were rare. It was found that In the B. pseudomallei group, it was associated with a younger age in the group without infection, along with fever, abdominal pain, septic shock, SIRS, and was associated with diabetes than in the group without infection. The group that found the infection had a higher death rate, symptoms did not improve, and the death rate at 3 months was higher than the group that did not find the infection. This may be caused by the severity of the disease.