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KMID : 0614620160670050245
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Korean Journal of Gastroenterology
2016 Volume.67 No. 5 p.245 ~ p.252
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Septic Shock in Pyogenic Liver Abscess: Clinical Considerations
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Cho A-Reum
Lee Tae-Hee
Park Min-Ji
Oh Sun-Hee
Lee Joo-Ah
Park Joo-Ho
Ryu Ki-Hyun
Koo Hoon-Sup
Song Kyung-Ho
Kim Sun-Moon
Huh Kyu-Chan
Choi Young-Woo
Kang Young-Woo
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Abstract
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Background/Aims: Pyogenic liver abscess (PLA) is a life-threatening condition, despite advances in diagnostic technology and strategies for treatment. A strong predictor of mortality in this condition is septic shock. This study describes clinical, biochemical, and radiologic features in patients with PLA with or without septic shock, with the intent of describing risk factors for septic shock.
Methods: Of 358 patients with PLA enrolled, 30 suffered septic shock and the remaining 328 did not. We reviewed the medical records including etiologies, underlying diseases, laboratory, radiologic and microbiologic findings, methods of treatment and treatment outcomes.
Results: The case fatality rate was 6.1%. In univariate analysis, the presence of general weakness, mental change, low platelet level, prolonged PT, high BUN level, high creatinine level, low albumin level, high AST level, high CRP level, abscess size ＞6 cm, the presence of gas-forming abscess, APACHE II score ≥20, and the presence of Klebsiella pneumoniae infection were significantly associated with septic shock. Multivariate analysis showed the presence of mental change (p=0.004), gas-forming abscess (p=0.012), and K. pneumoniae infection (p=0.027) were independent predictors for septic shock.
Conclusions: The presence of mental change, gas-forming abscess, and K. pneumoniae infection were independent predictors for septic shock in patients with PLA.
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KEYWORD
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Pyogenic liver abscess, Septic shock, Mortality, APACHE II, Klebsiella pneumoniae
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