Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study


Por: Peris J, Bellot P, Roig P, Reus S, Carrascosa S, González-Alcaide G, Palazon J and Ramos J

Publicada: 21 jul 2017
Categoría: Geriatrics and gerontology

Resumen:
Background: To analyse the clinical, epidemiological, microbiological and prognostic differences of pyogenic liver abscess (PLA) in older (>= 65 years of age) versus younger patients (<65 years). Methods: Multicentre, retrospective cohort study in all patients with PLA admitted to two Spanish hospitals from January 2000 to January 2014. Cases were divided into two age groups (<65 years and >= 65 years) for comparison of clinical, epidemiological and microbiological characteristics as well as treatment. Results: Of 98 patients analysed, 40 patients were younger than 65, and 58 were aged 65 or older. Significant associations in the older group were found with female sex (adjusted odds ratio [ORa] 9.0; 95% CI 1.4, 56), non-cryptogenic origin (ORa 14.5; 95% CI 1.6, 129), absence of chronic liver disease (ORa 14; 95% CI 1.3, 155), Escherichia coli infection (ORa 7.7; 95% CI 1.03, 58), and incidence of complications (ORa 2.3; 95% CI 1.04, 5.4). Mortality was 8.2% overall, although all deaths occurred in the older group (8/58; 13.8%) (p = 0.02). Discussion: Our results are in consonance with other published studies. Older patients with PLA tend to present more anomalies in the biliary tract (Kai et. al, World J Gastroenterol 18: 2948-295, 2012, Rahimian et. al, Clin Infect Dis 39: 1654-9, 2004, Seeto, Medicine (Baltimore) 75: 99-113, 1996, Kao et. al, Aliment Pharmacol Ther 36: 467-76, 2012, Lai et. al, Gastroenterology 146: 129-37, 2014), while younger patients are more often male and present more commonly with previous liver disease (especially related to alcohol) and cryptogenic PLA. Conclusion: In patients aged 65 or older, PLA was more common in women and in those with a history of biliary disease, and E. coli was the most frequent bacterium. Mortality was also higher in the older group.
ISSN: 14712318





BMC GERIATRICS
Editorial
BioMed Central, 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 17 Número:
Páginas: 161-161
WOS Id: 000406611900004
ID de PubMed: 28732474
imagen Green Published, gold

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