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.

Risk factors indicating the need for surgical therapy in patients with pyogenic liver abscesses

“…The overall median age of our patients was 68 years, which is higher than that of other reported large series that showed a mean age between 52 and 62 years [1,15,[24][25][26][27].…”

A population‐based study of pyogenic liver abscess in Korea: Incidence, mortality and temporal trends during 2007‐2017

“…Although less influential than cancer, diabetes showed a significant effect on in‐hospital mortality. Similarly, previous studies have reported cancer and diabetes as risk factors for PLA mortality 40‐45 …”

Multidisciplinary out-patient treatment with monitoring by telemedicine for a large-volume multifocal pyogenic liver abscess in times of the pandemic

“…All current data show that without doubt good therapy of all risk factors, such as diabetes mellitus, is crucial for the prognosis of the disease. [19][20][21][22] This also applies to the case described here. However, the optimal therapy for diabetes mellitus can only be achieved through the cooperation of the patient and the close supervision by the GP s. This is also possible via telemedical offers.…”