A Population-Based Study of Unfavorable Prognostic Factors Associated With Pyogenic Liver Abscess

BACKGROUND: Pyogenic liver abscess (PLA) is a rare entity that is associated with substantial mortality and morbidity. Our objective was to investigate variables associated with mortality and subsequent PLA in patients diagnosed with PLA in southern Sweden. METHODS: We conducted a population-based observational study comprising all episodes of PLA that occurred between 2011 and 2020 in the county of Skåne, southern Sweden. The primary outcome was defined as all-cause 90-day mortality and the secondary outcome was defined as the occurrence of a subsequent PLA. RESULTS: A total of 452 episodes of PLA occurred in 360 patients during the study period. The 90-day mortality rate was 16% (n = 58) and the subsequent PLA rate was 20% (n = 92). In a multivariable logistic regression model, female sex (odds ratio [OR], 2.0 [95% confidence interval {CI}, 1.1–3.9]), malignancy (OR, 3.7 [95% CI, 1.9–7.1]), liver failure (OR, 6.3 [95% CI, 2.7–14.5]), and polymicrobial findings (OR, 3.8 [95% CI, 2.2–6.9]) were associated with death within 90 days (P < .05). Male sex (OR, 2.1 [95% CI, 1.2–3.6]), malignancy (OR, 2.1 [95% CI, 1.3–3.6]), age (64–74 years: OR, 2.5 [95% CI, 1.3–4.8]), and chronic liver disease (OR, 3.0 [95% CI, 1.4–6.5]) were associated with the risk of subsequent PLA (P ≤ .01). CONCLUSIONS: Identifying different clinical variables associated with an unfavorable outcome may improve the management and treatment of patients with PLA and thus prevent the risk of death and subsequent PLA.