Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients
Yonsei Medical Journal
; : 519-528, 2015.
Article
de En
| WPRIM
| ID: wpr-141609
Bibliothèque responsable:
WPRO
ABSTRACT
PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Infections bactériennes
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Infections à Klebsiella
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Tomodensitométrie
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Modèles logistiques
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Analyse multifactorielle
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Études rétrospectives
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Courbe ROC
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Klebsiella pneumoniae
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Durée du séjour
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Abcès du foie
Type d'étude:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limites du sujet:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
langue:
En
Texte intégral:
Yonsei Medical Journal
Année:
2015
Type:
Article