Pneumonia is an independent risk factor for pyogenic liver abscess: A population-based, nested, case-control study

Sai-Wai Ho; Chao-Bin Yeh; Shun-Fa Yang; Han-Wei Yeh; Jing-Yang Huang; Ying-Hock Teng

doi:10.1371/journal.pone.0178571

Pneumonia is an independent risk factor for pyogenic liver abscess: A population-based, nested, case-control study

PLoS One. 2017 Jun 1;12(6):e0178571. doi: 10.1371/journal.pone.0178571. eCollection 2017.

Authors

Sai-Wai Ho^{1

2

3}, Chao-Bin Yeh^{1

2}, Shun-Fa Yang^{3

4}, Han-Wei Yeh⁵, Jing-Yang Huang⁴, Ying-Hock Teng^{1

2}

Affiliations

¹ Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
² Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
³ Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁴ Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁵ School of Medicine, Chang Gung University, Taoyuan City, Taiwan.

Abstract

Background: Bacteremic pneumonia is considered a potential cause of distal organ abscess formation. Therefore, we hypothesize that pneumonia is a risk factor for pyogenic liver abscess (PLA).The aim of this study is to explore the association between pneumonia and PLA.

Methodology/principal findings: A nationwide, population-based, nested, case-control study was conducted using data from the Taiwan National Health Insurance Research Database. In total, 494 patients with PLA and 1,976 propensity score matched controls were enrolled. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) in patients with exposure to pneumonia before PLA. After matched and adjusted for confounding factors including age, sex, urbanization, income, chronic liver disease, alcohol-related disease, biliary stone, chronic kidney disease, diabetes mellitus, chronic liver disease, and cancer, hospitalization for pneumonia remained an independent risk factor for PLA with an aORs of 2.104 [95% confidence interval (CI) = 1.309-3.379, p = 0.0021]. Moreover, the aORs were significantly higher among patients hospitalized for pneumonia within 30 days (aORs = 10.73, 95% CI = 3.381-34.054), 30-90 days (aORs = 4.698, 95% CI = 1.541-14.327) and 90-180 (aORs = 4.000, 95% CI = 1.158-13.817) days before PLA diagnosis.

Conclusion: Pneumonia is an independent risk factor for subsequent PLA. Moreover, hospitalization for pneumonia within 180 days before PLA diagnosis was associated with an increased risk of PLA.

MeSH terms

Adult
Aged
Case-Control Studies
Female
Humans
Liver Abscess, Pyogenic / complications*
Male
Middle Aged
Pneumonia / complications*
Risk Factors

Grants and funding

This study was partly based on data from the NHIRD provided by the NHI Administration, Ministry of Health and Welfare, and managed by the National Health Research Institutes (registration number: NHIRD-104-148). The interpretation and conclusions contained herein do not represent those of the NHI Administration, Ministry of Health and Welfare, or National Health Research Institutes. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.