Pyogenic Liver Abscess in the Elderly

Background: We analyzed the characteristics of elderly patients with pyogenic liver abscess, including clinical features, laboratory analyses and outcomes. Methods: A retrospective review of patient records from January 1, 2007 to June 30, 2008, identified 140 cases of liver abscess hospitalized in a medical center in northern Taiwan. Patients transferred from other hospitals, or those who had amoebic, fungal, traumatic or iatrogenic LA were excluded, and 122 cases were enrolled. We divided patients into two groups: an elderly group aged ≥ 65 years, and a non-elderly group. We collected information on clinical manifestations, laboratory data, imaging, blood and pus culture, and surgical findings for statistical analyses. Results: We compared the elderly and the non-elderly with pyogenic liver abscess with respect to diabetes history (p = 0.03), presence of fever (p = 0.19), days of fever before hospital visit (p = 0.001), abdominal pain (p = 0.08), diarrhea (p = 0.36), shock (p = 0.25), white blood cell count (p = 0.70), serum glucose (p = 0.49), aspartate aminotransferase (p = 0.95), length of hospital stay (p = 0.10), and mortality (p = 0.12). Most positive results in cultures were for Klebsiella pneumoniae, and the positive rates in culture of blood and pus were 43% and 60%, respectively. Conclusion: We found that there was no significant statistical difference between elderly and non-elderly pyogenic liver abscess patients in the presence of fever, abdominal pain, diarrhea, shock, white blood cell count, serum glucose, aspartate aminotransferase, hospital stay, and mortality. The elderly pyogenic liver abscess patients had fewer days of fever before hospital visit (2.2 ± 2.2 vs. 6.3 ± 6.9; p = 0.001). The elderly were taken to hospital earlier, because their families were more concerned about their constitutional symptoms. More cases of diabetes in the elderly pyogenic liver abscess group (44.7% vs. 39.3%) may arise because of more diabetes in the elderly population