Epidemiology and prognostic factors of liver abscess complications in northeastern Mexico

Abstract

Background

Amoebic abscesses (AA) are the most common cause of hepatic abscesses (HA) in the world and pyogenic abscesses (PA) in the western world. Complications of HA are sepsis, empyema by direct extension or abscess rupture.

Objective

To determine the epidemiology and prognostic factors of complications in patients with hepatic abscess in northeastern Mexico.

Material and methods

Patients with diagnosis of hepatic abscess in the University Hospital “Dr. José Eleuterio González” between 2011 and 2015. The study has a retrospective design.

Results

A total of 150 patients were reviewed, the most common symptoms were abdominal pain and fever. The etiology was 74 pyogenic, 28 amoebic, and unidentified in 48 patients. The most common agent was Klebsiella pneumoniae. Conservative management was given to 16 (17.3%) cases. The mortality was 18 patients (12%). The prognostic variables of complication were abdominal pain, respiratory rate, ALT > 154 IU/L, hemoglobin less than 10 g/dL, presence of a perforated abscess, and performing a second procedure. Mortality and hospitalization increased in the presence of complications.

Discussion

A prevalence of 20% of diabetes mellitus was observed in our patients. Mortality of PA, when associated with K. pneumoniae, ranges from 6 to 17%.

Conclusions

The predominant etiology remains pyogenic despite being an endemic country for amoebiasis. In our study, because of lower morbidity and mortality rate, the first choice of treatment was puncture of the abscess.