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Chi-Hua Yen

Publications and source records attributed to Chi-Hua Yen.

4 recordsLinked to original sources
PubMed2005

Comparison of pyogenic liver abscesses of biliary and cryptogenic origin. An eight-year analysis in a University Hospital.

OBJECTIVES: The aim of this study is to delineate the clinical features of pyogenic liver abscesses of biliary and cryptogenic origin, and to compare the differences in outcome of patients between the two groups. METHODS: We studied 86 patients, aged 19 years or older, with pyogenic liver abscess admitted to Chung Shan Medical University Hospital, Taichung, Taiwan, between January 1996 and December 2003. The demographic data and medical information of the patients were reviewed and recorded. Of the 86 patients, 34 were classified into the biliary group and 52 were classified into the cryptogenic group. RESULTS: Patients with pyogenic liver abscesses of biliary origin had a higher frequency of underlying malignancy and Murphy's sign compared to those with pyogenic liver abscesses of cryptogenic origin. With respect to specific pathogens, Escherichia coli were more prevalent in the biliary group while Klebsiella pneumoniae were more prevalent in the cryptogenic group. Anaerobic isolates were less frequently cultured in the cryptogenic group than in the biliary group. After adjustment for age, sex, and the duration of symptoms before admission, there was no difference in mortality between both groups (biliary vs cryptogenic: 15% vs 8%; adjusted OR, 1.43; 95% CI, 0.24-8.25; p = 0.899). After adjustment for confounders, patients in the biliary group had higher frequencies of time to defervesce >1 week after admission (68% vs 40%; adjusted OR, 3.05; 95% CI, 1.09-9.04, p = 0.030) and hospital stay >3 weeks (47% vs 15%; adjusted OR, 4.34; 95% CI, 1.45-13.91; p = 0.007) than those in the cryptogenic group. CONCLUSIONS: This report highlights that pyogenic liver abscesses of cryptogenic origin had a benign clinical response, which was associated with shorter duration of hospitalisation and time to defervesce after admission, compared to those of biliary origin.

Adult↗
PubMed2005

Pyogenic liver abscesses with Escherichia coli: etiology, clinical course, outcome, and prognostic factors.

BACKGROUND: To investigate the clinical characteristics, outcome, and prognostic factors related to mortality in patients with Escherichia coli liver abscess. METHODS: We retrospectively analyzed 72 patients aged 18 years and older who were diagnosed as having E. coli liver abscesses from July 1996 to June 2002 at two medical centers in Taiwan. RESULTS: The overall mortality rate was 26.4%. The majority of E. coli liver abscesses was solitary, involved the right lobe of the liver, and comprised polymicrobial infections. The cause of the liver abscess involved the biliary system in 48 patients (66.7%). The most common concomitant diseases were diabetes mellitus (30.6%) and underlying malignancy (30.6%). Metastatic infection was found in 4 patients (5.6%). Multivariate analysis revealed that underlying malignancy (p = 0.034), profound hypoalbuminemia (<2.5 g/dl) (p = 0.008), and multiple abscesses (p = 0.004) were the most significantly prognostic factors for mortality. CONCLUSION: The predominant causes of E. coli liver abscess were biliary diseases. This report also highlights that E. coli liver abscess has a relatively high mortality rate, which is associated with underlying malignancy, multiple abscesses and profound hypoalbuminemia.

Adolescent↗
PubMed2004

Comparison of pyogenic liver abscess caused by non-Klebsiella pneumoniae and Klebsiella pneumoniae.

From January 1996 to April 2002, a total of 248 patients with pyogenic liver abscess were enrolled in this study. Abscesses caused by Klebsiella pneumoniae accounted for 69% (171) of cases. Abscesses caused by K. pneumoniae were more strongly associated with diabetes mellitus or impaired fasting glucose than liver abscesses caused by non-K. pneumoniae (70.2% vs 32.5%). Solitary abscess and monomicrobial isolates were more frequent in the K. pneumoniae group than that in the non-K. pneumoniae group. A total of 42 patients were treated with antibiotics alone. Antibiotics treatment was combined with other procedures, including single aspiration in 23 patients, percutaneous drainage in 176 and surgical drainage in 7. A higher incidence of metastatic infections occurred in the K. pneumoniae group than in the non-K. pneumoniae group (14.6% vs 3.8%). By contrast, the mortality rate of the K. pneumoniae group was lower than that of non-K. pneumoniae group (4.1% vs 20.8%). There was no significant difference in the relapse rate between these 2 groups (6.5% vs 6.4%). We also found that the presence of respiratory symptoms (including cough, dyspnea, or chest distress), size of abscess > or =5 cm in diameter and non-K. pneumoniae pathogens were significant prognostic factors for mortality.

Adolescent↗