SSAT - Trends and Characteristics of Hepatic Abscess: a 5 Year Inpatient Review

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Trends and Characteristics of Hepatic Abscess: a 5 Year Inpatient Review
Katharine Kishiyama^*, Gregory Burgoyne, Richard Heitmiller

Surgery, Medstar Union Memorial Hospital, Baltimore, MD

Introduction: Hepatic abscesses are uncommon but usually require hospital admission for antibiotics and/or drainage. We aim to characterize patient demographics, risk factors associated with mortality and the management of hepatic abscesses.
Methods: The National Inpatient Sample database was utilized to extract data from hospital stays from 2006-2010 with primary diagnosis ICD-9 code 572.0 (hepatic abscess). Amebic liver abscesses (ICD-9 006.3) were not included. Data analysis included age, gender, mortality, length of stay (LOS), total charges, diagnosis & procedure codes.
Results: A total of 23,111 patients were included (mean 4,622 patients annually). 59% were male, 41% female with a mean age of 58.6 years. Mean mortality rate was 1.5% (range 0.9-1.9%). Average LOS was 9.9 days. Mean hospital charges were \,783. Common co-morbid conditions included hypertension, anemia, diabetes, hyperlipidemia, GERD and diverticulosis. Diseases associated with a higher mortality were cholangitis (10.9%), acute cholecystitis (6.1%), acute renal failure (6.0%), sepsis (5.1%), cirrhosis (4.9%), pleural effusion (3.5%), chronic renal failure (3.0%), malnutrition (2.7%) and atelectasis (2.4%). 9.8% of patients had no procedure performed. 66% had a percutaneous aspiration of the liver with a mortality rate of 0.8% (LOS 20.2 days) while 5.5% underwent operative intervention with either hepatotomy and/or partial hepatectomy with a mortality of 4.8% (LOS 14.6 days).
Conclusion: Hepatic abscesses are uncommon and present in older patients. Mortality is low overall but higher with biliary infection and liver or renal dysfunction. Most patients undergo percutaneous aspiration or no intervention with low mortality while those who undergo operative intervention have a six times higher risk of mortality.

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