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. 2019 May 30;3(6):474-479.
doi: 10.1002/jgh3.12183. eCollection 2019 Dec.

Evaluation of factors associated with complications in amoebic liver abscess in a predominantly toddy-drinking population: A retrospective study of 198 cases

Ashish K Jha  1 , Praveen Jha  1 , Madhur Chaudhary  1 , Shubham Purkayastha  1 , Sanjeev K Jha  1 , Ravish Ranjan  1 , Rajeev N Priyadarshi  2 , Ramesh Kumar  3
Affiliations

Evaluation of factors associated with complications in amoebic liver abscess in a predominantly toddy-drinking population: A retrospective study of 198 cases

Ashish K Jha et al. JGH Open. .

Abstract

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.

Keywords: Entamoeba histolytica; amoebic liver abscess; complication; interventional therapy; palm wine; prognosis; tari; toddy.

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Figures

Figure 1
Figure 1
Flow chart showing the screening of ALA patients and their management and outcomes.
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