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1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study

BACKGROUND: Pyogenic liver abscess (PLA) is a significant cause of morbidity and mortality. Epidemiological data regarding risk factors and outcome determinants are often ascertained from referral population bases. We utilized a population-based study design to better understand PLA. METHODS: Calgar...

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Autores principales: Losie, Jennifer A, Lam, John, Gregson, Dan, Parkins, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809433/
http://dx.doi.org/10.1093/ofid/ofz360.1368
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author Losie, Jennifer A
Lam, John
Gregson, Dan
Parkins, Michael
author_facet Losie, Jennifer A
Lam, John
Gregson, Dan
Parkins, Michael
author_sort Losie, Jennifer A
collection PubMed
description BACKGROUND: Pyogenic liver abscess (PLA) is a significant cause of morbidity and mortality. Epidemiological data regarding risk factors and outcome determinants are often ascertained from referral population bases. We utilized a population-based study design to better understand PLA. METHODS: Calgary Health Zone (CHZ) residents ≥18 years of age (population ~1.3 million) who were hospitalized with PLA in 2017 were included. Charts were manually reviewed to determine demographics and clinical outcomes. Univariate and multivariate logistic regression were used to assess for factors associated with 30-day mortality using STATA 15.1 (College Stn., TX). RESULTS: Forty-four patients with PLA were identified (39% female, median age 61 [IQR 56–68] years) corresponding to an incidence rate of 3.7 cases per 100,000 population. Prevalent co-morbidities with PLA included; hemodialysis dependence (4.5%), cancer (25%), diabetes (23%), and cirrhosis (6.8%), each of which was significantly more common (P < 0.05) than in the general population; 85.3X, 11.2X, 3.6X, 29.9X, respectively. Rates of other comorbidities including ischemic heart disease, COPD, and rheumatoid arthritis did not differ from general populations (P > 0.05). The etiology of PLA was established in 72% of cases, of which biliary was most common (48%). Most (91%) cases had at least one organism identified via blood or liver aspirate culture. The most common organisms were Streptococcus anginosus group (12), Klebsiella pneumoniae (11), Klebsiella oxytoca (6), Escherichia coli (4), and obligate anaerobes (3). Blood cultures were positive in 25/44 (56%) cases. Thirty-day mortality from admission was 11% and had multiple risk factors (Table-1). CONCLUSION: PLA in the CHZ is common and associated with high mortality. Understanding factors influencing PLA occurrence and outcome can assist in correctly identifying and optimally treating patients. [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68094332019-10-28 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study Losie, Jennifer A Lam, John Gregson, Dan Parkins, Michael Open Forum Infect Dis Abstracts BACKGROUND: Pyogenic liver abscess (PLA) is a significant cause of morbidity and mortality. Epidemiological data regarding risk factors and outcome determinants are often ascertained from referral population bases. We utilized a population-based study design to better understand PLA. METHODS: Calgary Health Zone (CHZ) residents ≥18 years of age (population ~1.3 million) who were hospitalized with PLA in 2017 were included. Charts were manually reviewed to determine demographics and clinical outcomes. Univariate and multivariate logistic regression were used to assess for factors associated with 30-day mortality using STATA 15.1 (College Stn., TX). RESULTS: Forty-four patients with PLA were identified (39% female, median age 61 [IQR 56–68] years) corresponding to an incidence rate of 3.7 cases per 100,000 population. Prevalent co-morbidities with PLA included; hemodialysis dependence (4.5%), cancer (25%), diabetes (23%), and cirrhosis (6.8%), each of which was significantly more common (P < 0.05) than in the general population; 85.3X, 11.2X, 3.6X, 29.9X, respectively. Rates of other comorbidities including ischemic heart disease, COPD, and rheumatoid arthritis did not differ from general populations (P > 0.05). The etiology of PLA was established in 72% of cases, of which biliary was most common (48%). Most (91%) cases had at least one organism identified via blood or liver aspirate culture. The most common organisms were Streptococcus anginosus group (12), Klebsiella pneumoniae (11), Klebsiella oxytoca (6), Escherichia coli (4), and obligate anaerobes (3). Blood cultures were positive in 25/44 (56%) cases. Thirty-day mortality from admission was 11% and had multiple risk factors (Table-1). CONCLUSION: PLA in the CHZ is common and associated with high mortality. Understanding factors influencing PLA occurrence and outcome can assist in correctly identifying and optimally treating patients. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809433/ http://dx.doi.org/10.1093/ofid/ofz360.1368 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Losie, Jennifer A
Lam, John
Gregson, Dan
Parkins, Michael
1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title_full 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title_fullStr 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title_full_unstemmed 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title_short 1504. Epidemiology and Etiology of Pyogenic Liver Abscess in the Calgary Health Zone: A Population-Based Study
title_sort 1504. epidemiology and etiology of pyogenic liver abscess in the calgary health zone: a population-based study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809433/
http://dx.doi.org/10.1093/ofid/ofz360.1368
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