Predictors of septic shock in initially stable patients with pyogenic liver abscess.
Scand J Gastroenterol
; 52(5): 589-594, 2017 May.
Article
in En
| MEDLINE
| ID: mdl-28270040
ABSTRACT
OBJECTIVES:
The incidence of pyogenic liver abscess (PLA), a life-threatening condition, is increasing worldwide. This study was designed to evaluate clinical features and outcomes in initially stable patients with PLA and to determine the predictors of septic shock.METHODS:
The medical records of all adult patients who were hemodynamically stable and diagnosed with PLA in the emergency department from January 2010 to December 2014, inclusive, were reviewed. The primary outcome was septic shock.RESULTS:
A review of medical records identified 453 patients (66.7% male), of mean age 61.4 years, diagnosed with PLA. Of these patients, 73 (16.1%) had septic shock and 10 (2.2%) died in-hospital. Of the 73 patients with septic shock, nine (12.3%) died in-hospital. The most common symptom was fever (79.5%), and the most common infectious agent was Klebsiella pneumoniae. Septic shock was significantly associated with age ≥60 years [odds ratio (OR) 2.99, 95% confidence interval (CI) 1.38-6.48], malignancy (OR 2.11, 95% CI 1.08-4.09), systolic blood pressure <100 mmHg (OR 3.63, 95% CI 1.43-9.21), respiratory rate ≥24/min (OR 3.15, 95% CI 1.20-8.28) and lactate concentration ≥2 mmol/L (OR 4.92, 95% CI 2.51-9.64). Septic shock also tended to be associated with procalcitonin concentration, but this was not statistically significant (OR 3.42, 95% CI 0.96-12.18).CONCLUSIONS:
Septic shock was frequent in initially stable patients with PLA and was associated with older age, malignancy, low blood pressure, tachypnea and elevated lactate concentration.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Septic
/
Klebsiella Infections
/
Liver Abscess, Pyogenic
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Scand J Gastroenterol
Year:
2017
Type:
Article
Affiliation country:
South Korea