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Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact

Objective: To assess if hepatic abscess incidence in a Midwest cohort was higher in rural areas compared to metropolitan areas in relation to water infrastructure. Materials and methods: All cases of hepatic abscesses from Jan 1, 2016 through Dec 31, 2019 at Avera McKennan Hospital in Sioux Falls, S...

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Autores principales: Grassel, Meghan, Yim, Douglas, Shriver, Jackson, Redlin, Tanner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858610/
https://www.ncbi.nlm.nih.gov/pubmed/35223257
http://dx.doi.org/10.7759/cureus.21477
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author Grassel, Meghan
Yim, Douglas
Shriver, Jackson
Redlin, Tanner
author_facet Grassel, Meghan
Yim, Douglas
Shriver, Jackson
Redlin, Tanner
author_sort Grassel, Meghan
collection PubMed
description Objective: To assess if hepatic abscess incidence in a Midwest cohort was higher in rural areas compared to metropolitan areas in relation to water infrastructure. Materials and methods: All cases of hepatic abscesses from Jan 1, 2016 through Dec 31, 2019 at Avera McKennan Hospital in Sioux Falls, South Dakota (SD), were retrospectively collected. Chart review was completed for each case for risk factor analysis. Microbiology cultures and patient demographic data were collected including age, gender, hometown, and ethnicity. Risk factors assessed included a history of abdominal surgery, gallbladder disease, sepsis, diverticulitis, cancer, and diabetes. The incidence of hepatic abscesses was calculated using the Poisson rate test and confidence interval equation. Averages of each risk factor were calculated. Finally, hometown was utilized to create a heatmap of disease burden and compared to the density of private wells. Results: Our data yielded 116 confirmed adult hepatic abscesses between 2016 and 2019. The corrected incidence per 100,000 hospitalized patients per year is 95.66. The Poisson exact probability P-value was <0.01. Rural areas had a higher per capita incidence of abscesses and higher density of private wells. Conclusions: The incidence of hepatic abscesses is higher than national averages in this single-center study of Avera McKennan Hospital. Demographics, especially geographic location, play an important role in abscess rates. Rural location may be affecting the incidence of hepatic abscesses, explaining the much higher than expected incidence in this study. Infrastructure could be a contributing factor as much of the rural area is reliant on untreated groundwater.
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spelling pubmed-88586102022-02-24 Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact Grassel, Meghan Yim, Douglas Shriver, Jackson Redlin, Tanner Cureus Radiology Objective: To assess if hepatic abscess incidence in a Midwest cohort was higher in rural areas compared to metropolitan areas in relation to water infrastructure. Materials and methods: All cases of hepatic abscesses from Jan 1, 2016 through Dec 31, 2019 at Avera McKennan Hospital in Sioux Falls, South Dakota (SD), were retrospectively collected. Chart review was completed for each case for risk factor analysis. Microbiology cultures and patient demographic data were collected including age, gender, hometown, and ethnicity. Risk factors assessed included a history of abdominal surgery, gallbladder disease, sepsis, diverticulitis, cancer, and diabetes. The incidence of hepatic abscesses was calculated using the Poisson rate test and confidence interval equation. Averages of each risk factor were calculated. Finally, hometown was utilized to create a heatmap of disease burden and compared to the density of private wells. Results: Our data yielded 116 confirmed adult hepatic abscesses between 2016 and 2019. The corrected incidence per 100,000 hospitalized patients per year is 95.66. The Poisson exact probability P-value was <0.01. Rural areas had a higher per capita incidence of abscesses and higher density of private wells. Conclusions: The incidence of hepatic abscesses is higher than national averages in this single-center study of Avera McKennan Hospital. Demographics, especially geographic location, play an important role in abscess rates. Rural location may be affecting the incidence of hepatic abscesses, explaining the much higher than expected incidence in this study. Infrastructure could be a contributing factor as much of the rural area is reliant on untreated groundwater. Cureus 2022-01-21 /pmc/articles/PMC8858610/ /pubmed/35223257 http://dx.doi.org/10.7759/cureus.21477 Text en Copyright © 2022, Grassel et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Radiology
Grassel, Meghan
Yim, Douglas
Shriver, Jackson
Redlin, Tanner
Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title_full Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title_fullStr Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title_full_unstemmed Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title_short Increased Incidence of Pyogenic Liver Abscess in a Midwest System With Emphasis on Rural Impact
title_sort increased incidence of pyogenic liver abscess in a midwest system with emphasis on rural impact
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858610/
https://www.ncbi.nlm.nih.gov/pubmed/35223257
http://dx.doi.org/10.7759/cureus.21477
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