Document Detail


Severity of disease as main predictor for mortality in patients with pyogenic liver abscess.
MedLine Citation:
PMID:  19268905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to explore the relationship between severity of illness at admission and mortality of patients with pyogenic liver abscess (PLA). METHODS: Medical records from 298 PLA patients > or =18 years old were reviewed. Severity of illness at admission was evaluated with the Acute Physiology and Chronic Health Evaluation (APACHE) II and the simplified acute physiology score (SAPS) II scoring systems. Stepwise logistic regression and receiver-operating-characteristic curve analyses were performed. RESULTS: The case-fatality rate was 10%. Multivariate analysis showed that APACHE II (P = .0004), SAPS II (P = .0008), the presence of gas-forming abscess (P <.0001), and the presence of anaerobic infection (P <.0001) all were associated with mortality. The area under the receiver-operating-characteristic curve was .884 (95% confidence interval .842 to .918) for APACHE II and .857 (95% confidence interval .812 to .895) for SAPS II, which were not significantly different (P = .490). The optimal cutoff APACHE II value of > or =15 had a sensitivity of 77% and a specificity of 92%, with a 20.3-fold risk of mortality (P <.0001). The SAPS II cutoff value of > or =28 had a sensitivity of 74% and a specificity of 82%, with a 7.2-fold risk of mortality (P = .008). CONCLUSIONS: Both the APACHE II and the SAPS II scoring methods are appropriate for assessing mortality of PLA patients.
Authors:
Shiuan-Chih Chen; Chi-Chou Huang; Shih-Jei Tsai; Chi-Hua Yen; Ding-Bang Lin; Po-Hui Wang; Chun-Chieh Chen; Meng-Chih Lee
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Publication Detail:
Type:  Journal Article     Date:  2009-03-06
Journal Detail:
Title:  American journal of surgery     Volume:  198     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-72     Citation Subset:  AIM; IM    
Affiliation:
Deparment of Family and Community Medicine, Chung Shan Medical University Hospital.
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MeSH Terms
Descriptor/Qualifier:
APACHE*
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use
Escherichia coli / isolation & purification
Escherichia coli Infections / complications
Female
Gases / metabolism
Humans
Klebsiella Infections / complications
Klebsiella pneumoniae / isolation & purification
Liver Abscess, Pyogenic / mortality*,  therapy
Male
Middle Aged
Multivariate Analysis
ROC Curve
Risk Factors
Sensitivity and Specificity
Severity of Illness Index*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gases

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