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Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study

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ABSTRACT

Whether patients who have undergone gastrectomy are at a high risk of developing pyogenic liver abscess (PLA) remains debatable. From the inpatient claims records of Taiwan’s National Health Insurance Research Database, we identified 33 834 patients with a history of 2000–2010 and135 336 controls without a history of gastrectomy. The 2cohorts were matched by age, sex, and admission year and followed-up until the end of 2011 for estimating the risk of PLA. Overall, the incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y). The adjusted hazard ratio (aHR) for the gastrectomy cohort obtained using the multivariate Cox proportional hazards regression model was 3.08 (95% confidence interval [CI] = 2.60–3.64). An elevated post gastrectomy PLA risk was observed in both men and women. Age-specific data revealed that the aHR for the gastrectomy cohort, compared with the control cohort, was the highest in patients younger than 50 years (aHR = 5.16, 95% CI = 2.96–9.01). An addition analysis showed that the gastrectomy cohort exhibited an elevated PLA risk regardless of whether the patients underwent total or partial gastrectomy. Patients with a history of gastrectomy exhibit a high risk of PLA.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of pyogenic liver abscess for patients with and without a history of gastrectomy.
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f1: Cumulative incidence of pyogenic liver abscess for patients with and without a history of gastrectomy.

Mentions: The overall incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y, respectively; Table 2). After adjustment for age, sex, and comorbidity, patients with a history of gastrectomy were associated with an increased risk of PLA compared with those without a history of gastrectomy (adjusted HR [aHR] = 3.08, 95% CI = 2.60–3.64). The Kaplan–Meier analysis revealed that the cumulative incidence curves of PLA were significantly higher in the gastrectomy cohort than in the control cohort by 0.84% (log-rank test P < 0.001; Fig. 1). Moreover, the two curves of PLA incidence separated gradually during the 12-year follow-up period (Fig. 1), suggesting the association between gastrectomy and PLA was not only related to short-term effects.


Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study
Cumulative incidence of pyogenic liver abscess for patients with and without a history of gastrectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037379&req=5

f1: Cumulative incidence of pyogenic liver abscess for patients with and without a history of gastrectomy.
Mentions: The overall incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y, respectively; Table 2). After adjustment for age, sex, and comorbidity, patients with a history of gastrectomy were associated with an increased risk of PLA compared with those without a history of gastrectomy (adjusted HR [aHR] = 3.08, 95% CI = 2.60–3.64). The Kaplan–Meier analysis revealed that the cumulative incidence curves of PLA were significantly higher in the gastrectomy cohort than in the control cohort by 0.84% (log-rank test P < 0.001; Fig. 1). Moreover, the two curves of PLA incidence separated gradually during the 12-year follow-up period (Fig. 1), suggesting the association between gastrectomy and PLA was not only related to short-term effects.

View Article: PubMed Central - PubMed

ABSTRACT

Whether patients who have undergone gastrectomy are at a high risk of developing pyogenic liver abscess (PLA) remains debatable. From the inpatient claims records of Taiwan&rsquo;s National Health Insurance Research Database, we identified 33&thinsp;834 patients with a history of 2000&ndash;2010 and135&thinsp;336 controls without a history of gastrectomy. The 2cohorts were matched by age, sex, and admission year and followed-up until the end of 2011 for estimating the risk of PLA. Overall, the incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10&thinsp;000 person-y). The adjusted hazard ratio (aHR) for the gastrectomy cohort obtained using the multivariate Cox proportional hazards regression model was 3.08 (95% confidence interval [CI]&thinsp;=&thinsp;2.60&ndash;3.64). An elevated post gastrectomy PLA risk was observed in both men and women. Age-specific data revealed that the aHR for the gastrectomy cohort, compared with the control cohort, was the highest in patients younger than 50 years (aHR&thinsp;=&thinsp;5.16, 95% CI&thinsp;=&thinsp;2.96&ndash;9.01). An addition analysis showed that the gastrectomy cohort exhibited an elevated PLA risk regardless of whether the patients underwent total or partial gastrectomy. Patients with a history of gastrectomy exhibit a high risk of PLA.

No MeSH data available.


Related in: MedlinePlus