Predictive factors for early aspiration in liver abscess

Abstract

Aim: To determine the predictive factors for early aspiration in liver abscess.

Methods: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.

Results: A total of 966 patients, 738 (76%) male, mean age 43 +/- 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age > or = 55 years, size of abscess > or = 5 cm, involvement of both lobes of the liver and duration of symptoms > or = 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group.

Conclusion: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.

Figure 1

Flow diagram of the patients with liver abscess and treatment received.