Increased risk and case fatality rate of pyogenic liver abscess in patients with liver cirrhosis: a nationwide study in Denmark.

Abstract

BACKGROUND:

Patients with liver cirrhosis are at increased risk of serious bacterial infections carrying a high case fatality rate. Case reports have suggested an association between liver cirrhosis and pyogenic liver abscess.

AIMS:

To estimate the risk and case fatality rate of pyogenic liver abscess in Danish patients with liver cirrhosis compared with the background population.

METHODS:

Identification of all patients with liver cirrhosis and pyogenic liver abscess over a 17 year period in the National Registry of Patients. Information on death was obtained from the Danish Central Person Registry.

RESULTS:

We identified 22 764 patients with liver cirrhosis and 665 patients with pyogenic liver abscess, of whom 21 were cirrhotics and 644 were non-cirrhotics. The crude incidence rate of liver abscess in cirrhotics was 23.3 (95% CI 14.4-35.6) per 100 000 person years. The age adjusted risk of liver abscess was increased 15-fold in patients with cirrhosis compared with the background population. The 30 day case fatality rates in patients with liver abscess and cirrhosis were 38.5% (13.9-68.4) in alcoholic cirrhosis and 62.5% (24.5-91.5) in non-alcoholic cirrhosis compared with 26.9% (23.5-30.5) in liver abscess patients from the background population. After adjustment for sex, age, and comorbidity, the relative risk of death was increased more than fourfold in alcoholic cirrhosis and non-alcoholic cirrhosis compared with the background population.

CONCLUSIONS:

Liver cirrhosis is a strong risk factor for pyogenic liver abscess associated with a poor prognosis.

• Authors: I Mølle, A M Thulstrup, H Vilstrup, H T Sørensen
• Journal: Gut (Gut) Vol. 48 Issue 2 Pg. 260-3 (Feb 2001) ISSN: 0017-5749 [Print] England
• PMID: 11156650 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Denmark (epidemiology)
• Female
• Humans
• Incidence
• Liver Abscess (epidemiology, etiology, mortality)
• Liver Cirrhosis (complications, epidemiology, mortality)
• Male
• Middle Aged
• Odds Ratio
• Poisson Distribution
• Prognosis
• Risk Factors
• Sex Factors