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Pyogenic liver abscess in patients with inflammatory bowel disease: a nationwide cohort study.
Liver Int. 2016 Jan; 36(1):136-44.LI

Abstract

BACKGROUND & AIMS

Pyogenic liver abscess (PLA) is a rare and severe extraintestinal complication in patients with inflammatory bowel disease (IBD). However, the incidence of PLA in patients with IBD remains unknown.

METHODS

A nationwide cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. Patients with IBD (N = 11 504) from 2000 to 2010 and control participants without IBD (N = 46 016) were included in this study. We analysed the risks of PLA by using competing-risks (death) regression models.

RESULTS

The incidence of PLA was higher in the IBD cohort than in the control cohort (6.72 vs 4.06 per 10 000 person-years), with an adjusted subhazard ratio (SHR) of 1.46 (95% confidence interval [CI], 1.01-2.12). Patients with IBD who required two or more hospitalizations per year and underwent laparotomy had an increased risk of PLA. Patients with ulcerative colitis were more likely to develop PLA than were those with Crohn's disease (incidence, 8.56 vs 5.45 per 10 000 person-years; adjusted SHR, 1.65 vs 1.32). Among the IBD cohort, age and gender did not affect PLA risk. Patients with diabetes mellitus or percutaneous aspiration of the gallbladder and biliary tract and who underwent endoscopic insertion of a biliary drainage tube exhibited a significantly increased risk of PLA.

CONCLUSIONS

Patients with IBD exhibited an increased risk of developing PLA, particularly those with ulcerative colitis. Knowledge of the expected frequency and potential risk for this severe extraintestinal infection may minimize the serious consequences.

Authors+Show Affiliations

Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. College of Medicine, China Medical University, Taichung, Taiwan.Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26012730

Citation

Lin, Jiun-Nong, et al. "Pyogenic Liver Abscess in Patients With Inflammatory Bowel Disease: a Nationwide Cohort Study." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 36, no. 1, 2016, pp. 136-44.
Lin JN, Lin CL, Lin MC, et al. Pyogenic liver abscess in patients with inflammatory bowel disease: a nationwide cohort study. Liver Int. 2016;36(1):136-44.
Lin, J. N., Lin, C. L., Lin, M. C., Lai, C. H., Lin, H. H., & Kao, C. H. (2016). Pyogenic liver abscess in patients with inflammatory bowel disease: a nationwide cohort study. Liver International : Official Journal of the International Association for the Study of the Liver, 36(1), 136-44. https://doi.org/10.1111/liv.12875
Lin JN, et al. Pyogenic Liver Abscess in Patients With Inflammatory Bowel Disease: a Nationwide Cohort Study. Liver Int. 2016;36(1):136-44. PubMed PMID: 26012730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pyogenic liver abscess in patients with inflammatory bowel disease: a nationwide cohort study. AU - Lin,Jiun-Nong, AU - Lin,Cheng-Li, AU - Lin,Ming-Chia, AU - Lai,Chung-Hsu, AU - Lin,Hsi-Hsun, AU - Kao,Chia-Hung, Y1 - 2015/06/07/ PY - 2015/04/06/received PY - 2015/05/19/accepted PY - 2015/5/28/entrez PY - 2015/5/28/pubmed PY - 2016/11/1/medline KW - Crohn's disease KW - inflammatory bowel disease KW - pyogenic liver abscess KW - ulcerative colitis SP - 136 EP - 44 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int VL - 36 IS - 1 N2 - BACKGROUND & AIMS: Pyogenic liver abscess (PLA) is a rare and severe extraintestinal complication in patients with inflammatory bowel disease (IBD). However, the incidence of PLA in patients with IBD remains unknown. METHODS: A nationwide cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. Patients with IBD (N = 11 504) from 2000 to 2010 and control participants without IBD (N = 46 016) were included in this study. We analysed the risks of PLA by using competing-risks (death) regression models. RESULTS: The incidence of PLA was higher in the IBD cohort than in the control cohort (6.72 vs 4.06 per 10 000 person-years), with an adjusted subhazard ratio (SHR) of 1.46 (95% confidence interval [CI], 1.01-2.12). Patients with IBD who required two or more hospitalizations per year and underwent laparotomy had an increased risk of PLA. Patients with ulcerative colitis were more likely to develop PLA than were those with Crohn's disease (incidence, 8.56 vs 5.45 per 10 000 person-years; adjusted SHR, 1.65 vs 1.32). Among the IBD cohort, age and gender did not affect PLA risk. Patients with diabetes mellitus or percutaneous aspiration of the gallbladder and biliary tract and who underwent endoscopic insertion of a biliary drainage tube exhibited a significantly increased risk of PLA. CONCLUSIONS: Patients with IBD exhibited an increased risk of developing PLA, particularly those with ulcerative colitis. Knowledge of the expected frequency and potential risk for this severe extraintestinal infection may minimize the serious consequences. SN - 1478-3231 UR - https://www.unboundmedicine.com/medline/citation/26012730/Pyogenic_liver_abscess_in_patients_with_inflammatory_bowel_disease:_a_nationwide_cohort_study_ L2 - https://doi.org/10.1111/liv.12875 DB - PRIME DP - Unbound Medicine ER -