Epidemiology of pyogenic liver abscesses in Germany: Analysis of incidence, risk factors and mortality rate based on routine data from statutory health insurance

Abstract

Background Pyogenic liver abscesses (PLAs) represent potentially life‐threatening abdominal conditions that require immediate diagnosis and therapy. European and American incidence figures vary between one and 15 per 100,000 per year. Structured epidemiological data for European countries are not available. Objective To systematically characterize the epidemiology and clinical outcome of PLA in Germany. Methods In representative statutory health insurance data from four million people in 2013–2019, the prevalence and incidence with clinical coding of International Statistical Classification of Diseases and Related Health Problems (ICD)‐10 code K75.0 were selected (n = 1118). Furthermore, demographics, relevant comorbidities, hospitalizations, mortality and complications were determined within one year. Results The incidence of PLA was approximately seven per 100,000. The average age at diagnosis was 66 years; 65% were male. Of these, biliary disease was documented in over 60% and infectious intestinal diseases were found in 21% within the same or previous calendar year. PLA patients had high comorbidity indices. Liver transplant status, malignancies of the liver and biliary system, liver cirrhosis and pancreatitis were strongly associated. Intensive care was documented in 27% of PLA cases. Nine percent died within 12 months, most with an underlying malignant disease. Conclusion Pyogenic liver abscess is a rare disease with high morbidity. Predisposing and risk factors include intestinal and biliary diseases as well as hepatic malignancies. Further research should focus on PLA therapy within prospective surveys and controlled clinical trials.

Pyogenic Liver Abscess Caused by Staphylococcus hominis: A Case Report

“…Pyogenic liver abscess is a common infectious liver disease worldwide with a mortality of 2%-12% 8,9 . It has been estimated that the incidence of pyogenic liver abscess is higher in Asian countries, with approximately 12–18 patients per 100,000 population per year 10 .…”

“…Pyogenic liver abscess is a common infectious liver disease worldwide with a mortality of 2%-12%. 8,9 It has been estimated that the incidence of pyogenic liver abscess is higher in Asian countries, with approximately 12-18 patients per 100,000 population per year. 10 It has been reported that recently the incidence is increasing due to the application of interventional therapy in hepatobiliary diseases and the aggravation of multidrug resistance in microorganisms, and can further increase in patients with diabetes mellitus or in those receiving immunosuppressive therapy.…”

Klebsiellen-Leberabszess

“…Die Rezidivrate beträgt etwa 15 %insbesondere bei multiplen oder bilobulären Abszessen (25 % und 36 %), Abszessen durch multiresistente Erreger (46 %) oder vorausgegangenen Cholangitiden (85 %) [35]. Die 1-Jahres-Mortalität wird in Deutschland mit 9 % angegeben und v. a. durch maligne Grunderkrankungen determiniert [11]. Für den Verlauf von KLA liegen noch keine spezifischen…”

A rare Danish case of Yersinia pseudotuberculosis pyogenic liver abscess

“…A pyogenic liver abscess (PLA) is pus‐filled cavity within the liver due to a bacterial infection 3 . The annual incidence of PLA has been reported between 1 and 7 cases per 100,000 in some Western Countries and higher among men than women, 4–6 while higher rates have been reported in Taiwan (17.6 per 100,000) with Klebsiella pneumoniae as the primary pathogen 7 . The majority of PLA occurs in patients with pre‐existing gastrointestinal or biliary disease and originates from hematogenous spread though the portal vein.…”