Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care

貢獻的翻譯標題: 需加護病房治療之細菌性肝膿瘍病患的死亡預測因子

羅 鴻源(Horng-Yuan Lou), 羅 鴻基(Hong-Ji Luo), 謝 清睿(Ching-Ruey Hsieh), 張 甄(Tiong Cheng), 鄭 仰志(Yang-Chih Cheng), 方 聖惟(Sheng-Uei Fang), 劉 正典(Jean-Dean Liu), 潘 憲(Shiann Pan), 張 君照(Chun-Chao Chang)

研究成果: 雜誌貢獻文章

摘要

背景:細菌性肝膿瘍在診斷及治療上雖然有所進步,但是對於重症病患其死亡率仍然很高,針對細菌性肝膿瘍重症病患的研究發表目前很少,本研究主要探討需要於加護病房治療的細菌性肝膿瘍病患導致死亡的預測因子。
方法:自2003年1月至2009年6月期間,共有35位病患因爲細菌性肝膿瘍需要於加護病房治療進入本回溯性研究,我們記錄了相關資料,包含性別、年齡、合併其他疾病、發病天數、發燒、腹痛、住院直接進入加護病房治療、肝膿瘍破裂、休克、腎衰竭、呼吸衰竭、APACHE Ⅱ數值、獲得診斷及引流所需天數、需要手術、肝膿瘍大小及位置、肝膿瘍含有氣體、單發肝膿瘍、多發性菌種、Klebsiella pneumoniae肝膿瘍、血液及肝膿瘍抽吸培養、AST、ALT、albumin、total bilirubin及C-reactive protein。將病患分成存活及死亡兩組,使用SAS統計軟體作分析找出有差異之因子,再針對有差異之因子作單變項及多變項分析找出獨立危險因子,接著找出對於獨立危險因子預測最佳準確率的絕對值。
結果:APACHE Ⅱ數值、肝膿瘍大小及肝膿瘍含有氣體,在單變項分析時爲與死亡相關之因子,於多變項分析時僅APACHE Ⅱ數值高(OR=1.387; 95% CI=1.106-1.739)及肝膿瘍比較大(OR=2.986; 95%CI=1.060-3.723)爲獨立之危險因子。進一步分析發現APACHE Ⅱ數值≥17及肝膿瘍直徑≥5公分有最佳之預測準確率。
結論:在細菌性肝膿瘍的重症病患,APACHE Ⅱ數值≥17及肝膿瘍直徑≥5公分與病患之死亡有關。
原文英語
頁(從 - 到)416-423
頁數8
期刊Gastroenterological Journal of Taiwan
27
發行號4
出版狀態已發佈 - 2010

指紋

Pyogenic Liver Abscess
Critical Care
APACHE
Mortality
Intensive Care Units
Liver Abscess
Liver
Critical Illness
Abscess
Multivariate Analysis
Gases
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)

引用此文

羅鴻源(Horng-Yuan L, 羅鴻基(Hong-Ji L, 謝清睿(Ching-Ruey H, 張甄(Tiong C, 鄭仰志(Yang-Chih C, 方聖惟(Sheng-Uei F, ... 張君照(Chun-Chao C (2010). Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care. Gastroenterological Journal of Taiwan, 27(4), 416-423.

Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care. / 羅鴻源(Horng-Yuan Lou); 羅鴻基(Hong-Ji Luo); 謝清睿(Ching-Ruey Hsieh); 張甄(Tiong Cheng); 鄭仰志(Yang-Chih Cheng); 方聖惟(Sheng-Uei Fang); 劉正典(Jean-Dean Liu); 潘憲(Shiann Pan); 張君照(Chun-Chao Chang).

於: Gastroenterological Journal of Taiwan, 卷 27, 編號 4, 2010, p. 416-423.

研究成果: 雜誌貢獻文章

羅鴻源(Horng-YuanL, 羅鴻基(Hong-JiL, 謝清睿(Ching-RueyH, 張甄(TiongC, 鄭仰志(Yang-ChihC, 方聖惟(Sheng-UeiF, 劉正典(Jean-DeanL, 潘憲(ShiannP & 張君照(Chun-ChaoC 2010, 'Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care', Gastroenterological Journal of Taiwan, 卷 27, 編號 4, 頁 416-423.
羅鴻源(Horng-YuanL, 羅鴻基(Hong-JiL, 謝清睿(Ching-RueyH, 張甄(TiongC, 鄭仰志(Yang-ChihC, 方聖惟(Sheng-UeiF 等. Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care. Gastroenterological Journal of Taiwan. 2010;27(4):416-423.
羅鴻源(Horng-Yuan Lou) ; 羅鴻基(Hong-Ji Luo) ; 謝清睿(Ching-Ruey Hsieh) ; 張甄(Tiong Cheng) ; 鄭仰志(Yang-Chih Cheng) ; 方聖惟(Sheng-Uei Fang) ; 劉正典(Jean-Dean Liu) ; 潘憲(Shiann Pan) ; 張君照(Chun-Chao Chang). / Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care. 於: Gastroenterological Journal of Taiwan. 2010 ; 卷 27, 編號 4. 頁 416-423.
@article{9da8991f6a954fc1b86807e6658c576b,
title = "Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care",
abstract = "Background: Despite progress in the diagnosis and management of pyogenic liver abscess, the mortality rate remains high in critically ill patients. There have been limited studies on patients with pyogenic liver abscess requiring intensive care. The aim of this study was to assess the risk factors of mortality among patients with pyogenic liver abscess treated in intensive care unit (ICU).Methods: Thirty-five patients with pyogenic liver abscess admitted to ICU, between January 2003 and June 2009, were studied retrospectively. Parameters including general characteristics, clinical presentations, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores, features of liver abscess and laboratory data were reviewed. The main outcome measure was survival. Univariate and subsequent multivariate logistic regression analyses were performed to assess the risk factors for mortality. The best cut-off for each identified independent risk factor for mortality was then investigated.Results: Univariate analysis implicated APACHE Ⅱ scores on admission, abscess size and gas formation as prognostic factors of mortality. Multivariate analysis showed higher APACHE Ⅱ scores on ICU admission (OR=1.387; 95{\%} CI=1.106-1.739) and size of the liver abscess (OR=2.986; 95{\%} CI=1.060-3.723) as independent prognostic factors for mortality. Finally, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were found to be relatively more accurate in predicting mortality in the study population.Conclusion: In patients with pyogenic liver abscess requiring intensive care, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were accurate predictors of mortality.",
keywords = "細菌性肝膿瘍, 死亡率, pyogenic liver abscess, mortality",
author = "羅, {鴻源(Horng-Yuan Lou)} and 羅, {鴻基(Hong-Ji Luo)} and 謝, {清睿(Ching-Ruey Hsieh)} and 張, {甄(Tiong Cheng)} and 鄭, {仰志(Yang-Chih Cheng)} and 方, {聖惟(Sheng-Uei Fang)} and 劉, {正典(Jean-Dean Liu)} and 潘, {憲(Shiann Pan)} and 張, {君照(Chun-Chao Chang)}",
year = "2010",
language = "English",
volume = "27",
pages = "416--423",
journal = "Gastroenterological Journal of Taiwan",
issn = "1013-7696",
publisher = "臺灣消化系醫學會",
number = "4",

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TY - JOUR

T1 - Predictors of Mortality in Patients with Pyogenic Liver Abscess Requiring Intensive Care

AU - 羅, 鴻源(Horng-Yuan Lou)

AU - 羅, 鴻基(Hong-Ji Luo)

AU - 謝, 清睿(Ching-Ruey Hsieh)

AU - 張, 甄(Tiong Cheng)

AU - 鄭, 仰志(Yang-Chih Cheng)

AU - 方, 聖惟(Sheng-Uei Fang)

AU - 劉, 正典(Jean-Dean Liu)

AU - 潘, 憲(Shiann Pan)

AU - 張, 君照(Chun-Chao Chang)

PY - 2010

Y1 - 2010

N2 - Background: Despite progress in the diagnosis and management of pyogenic liver abscess, the mortality rate remains high in critically ill patients. There have been limited studies on patients with pyogenic liver abscess requiring intensive care. The aim of this study was to assess the risk factors of mortality among patients with pyogenic liver abscess treated in intensive care unit (ICU).Methods: Thirty-five patients with pyogenic liver abscess admitted to ICU, between January 2003 and June 2009, were studied retrospectively. Parameters including general characteristics, clinical presentations, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores, features of liver abscess and laboratory data were reviewed. The main outcome measure was survival. Univariate and subsequent multivariate logistic regression analyses were performed to assess the risk factors for mortality. The best cut-off for each identified independent risk factor for mortality was then investigated.Results: Univariate analysis implicated APACHE Ⅱ scores on admission, abscess size and gas formation as prognostic factors of mortality. Multivariate analysis showed higher APACHE Ⅱ scores on ICU admission (OR=1.387; 95% CI=1.106-1.739) and size of the liver abscess (OR=2.986; 95% CI=1.060-3.723) as independent prognostic factors for mortality. Finally, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were found to be relatively more accurate in predicting mortality in the study population.Conclusion: In patients with pyogenic liver abscess requiring intensive care, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were accurate predictors of mortality.

AB - Background: Despite progress in the diagnosis and management of pyogenic liver abscess, the mortality rate remains high in critically ill patients. There have been limited studies on patients with pyogenic liver abscess requiring intensive care. The aim of this study was to assess the risk factors of mortality among patients with pyogenic liver abscess treated in intensive care unit (ICU).Methods: Thirty-five patients with pyogenic liver abscess admitted to ICU, between January 2003 and June 2009, were studied retrospectively. Parameters including general characteristics, clinical presentations, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores, features of liver abscess and laboratory data were reviewed. The main outcome measure was survival. Univariate and subsequent multivariate logistic regression analyses were performed to assess the risk factors for mortality. The best cut-off for each identified independent risk factor for mortality was then investigated.Results: Univariate analysis implicated APACHE Ⅱ scores on admission, abscess size and gas formation as prognostic factors of mortality. Multivariate analysis showed higher APACHE Ⅱ scores on ICU admission (OR=1.387; 95% CI=1.106-1.739) and size of the liver abscess (OR=2.986; 95% CI=1.060-3.723) as independent prognostic factors for mortality. Finally, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were found to be relatively more accurate in predicting mortality in the study population.Conclusion: In patients with pyogenic liver abscess requiring intensive care, APACHE Ⅱ scores≥17 and the diameter of liver abscess≥5 cm were accurate predictors of mortality.

KW - 細菌性肝膿瘍

KW - 死亡率

KW - pyogenic liver abscess

KW - mortality

M3 - Article

VL - 27

SP - 416

EP - 423

JO - Gastroenterological Journal of Taiwan

JF - Gastroenterological Journal of Taiwan

SN - 1013-7696

IS - 4

ER -