Kuo et al identified risk factors associated with mortality in a patient with a pyogenic liver abscess. This can help to identify a patient who may benefit from more aggressive management. The authors are from Chung Shan Memorial University, Yuan-Lin Kuo Hospital, Chi Mei Medical Center and Taichung Hospital in Taiwan.
Patient selection: pyogenic liver abscess
Major risk factors for mortality from multivariate analysis:
(1) anaerobic infection (odds ratio 102)
(2) serum creatinine > 1.3 mg/dL (odds ratio 44)
(3) Mortality in Emergency Department Sepsis (MEDS) on admission >= 7 (41% mortality rate)
Other significant risk factors for mortality:
(1) serum total bilirubin > 1.3 mg/dL (odds ratio 16)
(2) malignancy (odds ratio 10)
(3) multiple abscesses (odds ratio 6)
(4) MEDS 4 to 6 on admission (10% mortality rate)
A MEDS >= 7 had a sensitivity of 76% and specificity of 81% for mortality
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