Predictive factors for early aspiration in liver abscess

Table 1 Clinical features of the patients with different types of liver abscess n (%)

Characteristics	Amebic	Pyogenic	Mixed	Indeterminate	P
	abscess	abscess	abscess	abscess	value
	(n = 661)	(n = 200)	(n = 32)	(n = 73)
Gender
Male	568 (86)	158 (79)	27 (84)	66 (90)	0.06
Female	93 (14)	42 (21)	5 (16)	7 (10)
Age
< 55 yr	471 (71)	146 (73)	25 (78)	52 (71)
≥ 55 yr	190 (29)	54 (27)	7 (22)	21 (29)	0.83
Duration of symptoms1
≥ 7 d	453 (69)	136 (68)	24 (75)	47 (64)	0.752
< 7 d	208 (32)	64 (32)	8 (25)	26 (36)
Jaundice (%)
No	534 (81)	170 (85)	26 (81)	64 (88)
Yes	126 (19)	30 (15)	6 (19)	9 (12)	0.341
Tender hepatomegaly
Yes	553 (84)	179 (90)	26 (81)	57 (78)	0.085
No	107 (16)	21 (10)	6 (19)	16 (22%)
Diabetes mellitus
No	546 (83)	166 (83)	25 (78)	60 (82)	0.925
Yes	115 (17)	34 (17)	7 (22)	13 (18)
Treatment
Aspiration not done	375 (57)	109 (54)	12 (37)	44 (60)	0.151
Aspiration done	286 (43)	91 (46)	20 (63)	29 (40)
Patient outcome
Alive	649 (98)	192 (96)	31 (97)	72 (99)
Died	12 (2)	8 (4)	1 (3)	1 (1)	0.352

¹Fever or abdominal pain.

Table 2 Clinical features of patients with liver abscess

Characteristics	Aspiration group (n = 426)	Non aspiration group (n = 540)	Odds ratio	95% CI	P value
Gender
Male	365 (85.7)	454 (84.1)	1.13	0.79-1.61	0.490
Female	61 (14.3)	86 (15.9)	1.00
Age
< 55 yr	282 (66.0)	412 (76.0)	1.00	1.2-2.2	0.001
≥ 55 yr	144 (34.0)a	128 (24.0)	1.60
Duration of symptoms1 (n%)
< 7 d	111(26.1)	195 (36.1)	1.00
≥ 7 d	315 (73.9)a	345 (63.9)	1.60	1.21-2.11	0.001
Jaundice (n%)
Yes	91 (21.4)a	80 (14.8)	1.55	1.18-2.17	0.009
No	335 (78.6)	459 (85.2)	1.00
Diabetes mellitus (n%)
Yes	70 (16.4)	99 (18.3)	0.87	0.62-1.22	0.440
No	356 (83.6)	441 (81.7)	1.00
Patient outcome (n%)
Alive	414 (97.2)	530 (98.1)	1.00	0.65-3.59	0.320
Died	12 (2.8)	10 (1.9)	1.53
Hospital stay (n%)
< 5 d	126 (29.6)	265 (49.1)	1.00
≥ 5 d	300 (70.4)a	275 (50.9)	2.29	1.75-2.99	0.001

Variable compared to reference category (OR = 1),

^aP < 0.05;

¹Fever or abdominal pain.

Table 3 Laboratory features of the patients with liver abscess

Characteristics (mean ± SD)	Aspiration group (n = 426)	Non aspiration group (n = 540)	Odds ratio	95% CI	P value
Total bilirubin (mg/dL)	2.55 ± 3.4	1.86 ± 2.2	1.090	1.04-1.15	0.001
ALT (IU/L)	81.29 ± 98.87	66.18 ± 75.9	1.002	1.000-1.004	0.010
Alkaline phosphatase (IU/L)	18.45 ± 141.3	86.8 ± 117.2	1.002	0.001-1.003	0.001
Albumin (g/L)	2.24 ± 0.50	2.42 ± 0.6	0.590	0.44-0.80	0.001
Serum creatinine (mg/dL)	1.37 ± 1.20	1.25 ± 0.8	1.130	0.99-1.28	0.070
Leukocyte counts (103/mm3)	20.09 ± 9.61	18.67 ± 8.03	1.010	1.004-1.030	0.010
Platelet counts (103/mm3)	357.69 ± 162.40a	328.33 ± 143.98	1.001	1.000-1.002	0.004

Variable compared to reference category (OR = 1),

^aP < 0.05; ALT: Alanine aminotransferase.

Table 4 Radiological features of patients with liver abscess (%)

Characteristics	Aspiration group (n = 426)	Non aspiration group (n = 540)	Odds ratio	95% CI	P value
No. of abscess
Single abscess	303 (71.1)	434 (80.4)	1.00
Multiple abscesses	123 (28.9)a	106 (19.6)	1.66	1.23-2.24	0.001
Site of lobe involvement
Right lobe	301 (70.7)	415 (76.9)	0.97	0.67-1.40
Left lobe	59 (13.8)	79 (14.6)	1.00	-	0.010
Both lobes	66 (15.5)a	46 (8.4)	1.92	1.15-3.18
Presence of gallstones
Yes	8 (1.9)a	11 (2.0)	0.92
No	418 (98.1)	529 (98.0)	1.00	0.36-2.30	0.860
Chest radiograph
Normal	235 (55.2)	334 (61.9)	1.00
Abnormal1	191 (44.8)a	206 (38.1)	1.31	1.01-1.70	0.030
Size of abscess
≤ 5 cm	121 (28.4)	209 (38.7)	1.00
> 5 cm	305 (71.6)a	331 (61.3)	1.59	1.21-2.09	0.001

¹Raised right hemi diaphragm, pleural effusion, and right lung base atelactasis. Variable compared to reference category (OR = 1),

^aP < 0.05.

Table 5 Independent predictors for aspiration of liver abscess

Factor	Coefficient	Adjusted	95% CI for	Wald
		odds ratio	adjusted odds ratio	P-value
Age
< 55 yr	0	11
≥ 55 yr	0.5135	1.6	1.2-2.2	0.001
Size of abscess
≤ 5 cm	0	11
> 5 cm	0.5324	1.6	1.2-2.09	0.001
Location of abscess
One lobe	0	11
Both lobes	0.7958	2.2	1.5-3.4	0.001
Duration of symptoms
< 7 d	0	11
≥ 7 d	0.4542	1.6	1.2-2.1	0.001

The parameter coefficient, adjusted odds ratio, 95% CI and Wald P-value, were estimated using multiple logistic regression.

¹Reference category.