Effect of Diabetes Mellitus on short-term prognosis of 227 pyogenic liver abscess patients after hospitalization

Abstract

Background: Pyogenic liver abscess (PLA) is an inflammatory disease with increasing incidence. When it occurs with diabetes mellitus (DM), risk of recurrence and the mortality may increase. However, the effect of DM on short-term prognosis of PLA patients after hospitalization remained unknown. Methods: 227 PLA patients who received treatment at the First Affiliated Hospital of Xi’an Jiaotong University from January 2011 to January 2018 were retrospectively enrolled. They were divided into two groups as DM group (n=61) and Non-DM group (n=166). In the DM group, HbA1C level <7% was considered to be good-control of glycaemia (n=23). The clinical characteristics and overall short-term survivals were analyzed. Results: The proportion of PLA patients with DM was 26.87%. In the DM group, there was a higher incidence of hypertension and Candida spp. infection. Conservative administration and percutaneous drainage were mainly used in patients with good- (60.87%) and poor-control (60.53%) of glycaemia, respectively. During follow-up, 24 (10.57%) died due to uncontrolled systemic infections and other serious complications. Compared with PLA patients without DM, patients in the DM group had significantly increased 6-month mortality rate after discharge (Log-Rank test, P =0.021). Poor-control of glycaemia did not reduce the six-month survival, while the recurrence rate of PLA within three months showed an almost 3-fold increase (13.16% vs. 4.35%). Further multivariate analyses found that DM was the only independent risk factor for the PLA six-month survival (odd ratio [OR]: 3.019, 95% confidence interval [CI]: 1.138-8.010, P =0.026). However, the blood glucose level had no significant effect on the short-term survival of PLA patients with DM (Log-Rank test, P =0.218). Conclusions: In PLA patients, DM aggravated short-term mortality and blood glucose levels should be well controlled.