Abscesos hepáticos: características clínico-epidemiológicas, microbiológicas y predictores de mortalidad

Introduction

Liver abscesses are the most common type of visceral abscess. Risk factors include diabetes mellitus, hepatobiliary diseases, liver transplantation, and proton pump inhibitor use. Diagnosis relies on imaging techniques and microbiological cultures. The aim of the study was to evaluate the clinical-epidemiological and microbiological characteristics of liver abscesses and their impact on patient prognosis.

Methods

Retrospective observational study conducted on 132 patients diagnosed with liver abscesses from 2011 to 2022 in a single hospital in Spain. Clinical, laboratory, and microbiological variables were compared, assessing mortality predictors using logistic regression and survival by treatment strategy using Cox regression.

Results

Female sex and biliary disease increase the risk of multiple liver abscesses. Liver abscess cultures are more effective for diagnosis than blood cultures. Polymicrobial blood cultures are more common in patients with a history of colorectal cancer. Early percutaneous drainage reduced hospitalization time, and broad-spectrum antibiotic therapy decreased the need for surgery. The in-hospital mortality rate was 15.1%, and was independently associated with diabetes mellitus, abscess size, and polymicrobial infection; surgery was linked to a higher mortality risk compared with drainage.

Conclusions

Liver abscess cultures are crucial for guiding antibiotic therapy, particularly given the high prevalence of polymicrobial infections. Mortality is linked to specific comorbidities and microbial findings. Early drainage and broad-spectrum antibiotics improve clinical outcomes.