Open AccessEvaluation of factors associated with complications in amoebic liver abscess in a predominantly toddy‐drinking population: A retrospective study of 198 cases
Author(s) -
Jha Ashish K,
Jha Praveen,
Chaudhary Madhur,
Purkayastha Shubham,
Jha Sanjeev K,
Ranjan Ravish,
Priyadarshi Rajeev N,
Kumar Ramesh
Publication year - 2019
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12183
Subject(s) - hypoalbuminemia , medicine , leukocytosis , hyponatremia , univariate analysis , gastroenterology , retrospective cohort study , surgery , multivariate analysis
Background and Aim Although the mortality rate has declined in recent years, amoebic liver abscesses (ALAs) still carry a substantial risk of morbidity. Studies regarding the indicators of severity, complication, or prognosis of ALA are limited in number and heterogeneous in methodology and results. Methods Clinicodemographic profile, therapeutic modalities, and outcomes of indoor ALA patients admitted between January 2016 and October 2017 were analyzed. An analysis of possible prognostic factors associated with complications and interventional therapy in patients with ALA was performed retrospectively. Results Data of 198 patients with ALA (mean age: 45 ± 12.1; M:F ratio: 193:5) were analyzed. The volume of abscess (503.1 ± 391.2: 300.2 ± 305.8 mL), elevated liver enzymes, and duration of hospital stay (11.98 ± 5.75): 10.23 ± 4.1 days) were significantly ( P < 0.05) higher in alcoholic, compared to nonalcoholic, individuals. On univariate analysis, older age, duration of alcohol consumption, smoking, leukocytosis, hyperbilirubinemia, hypoalbuminemia, hyponatremia, and a larger volume of abscess were found to be significantly ( P < 0.05) associated with complications. On multivariate analysis, older age, duration of alcohol consumption, smoking, leukocytosis, hyperbilirubinemia, hypoalbuminemia, and hyponatremia were found to be significantly ( P < 0.05) associated with complications. Male gender, hypoalbuminemia, and larger volume of abscess were significantly ( P < 0.05) associated with interventional treatment. Conclusion Older age, leukocytosis, hyperbilirubinemia, hypoalbuminemia, hyponatremia, chronic alcoholism, and smoking are independent factors significantly associated with complications in patients with ALA. Hypoalbuminemia, larger volume of abscess, and male gender are independent variables associated with the requirement of interventional therapy.