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

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’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.


The flow chart shows the study subjects’ selection.
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f2: The flow chart shows the study subjects’ selection.

Mentions: From inpatient claims data, we identified patients older than 20 years who had undergone partial gastrectomy (ICD-9-OP43.5, 43.6, 43.7, 43.8, 43.81, 43.82, 43.89) or total gastrectomy (ICD-9-OP 43.91 and43.99) from January 1, 2000 to December 31, 2010. Patients whose date of birth and sex were missing in the data and those with preexisting PLA (ICD-9-CM 572.0) were excluded. The index date was defined when the ICD 9 codes of gastrectomy was found within the NHIRD database. Usually, the index date was weeks after the patient was discharged or dead, mainly due to the process time for filing the reimbursement. For each gastrectomy patient, four comparisons were randomly selected from the pool of participants without gastrectomy and PLA at the baseline, frequency matched by the year of index date, age (every 5-year span), sex and comorbidity of diabetes (Fig. 2).


Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study
The flow chart shows the study subjects’ selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f2: The flow chart shows the study subjects’ selection.
Mentions: From inpatient claims data, we identified patients older than 20 years who had undergone partial gastrectomy (ICD-9-OP43.5, 43.6, 43.7, 43.8, 43.81, 43.82, 43.89) or total gastrectomy (ICD-9-OP 43.91 and43.99) from January 1, 2000 to December 31, 2010. Patients whose date of birth and sex were missing in the data and those with preexisting PLA (ICD-9-CM 572.0) were excluded. The index date was defined when the ICD 9 codes of gastrectomy was found within the NHIRD database. Usually, the index date was weeks after the patient was discharged or dead, mainly due to the process time for filing the reimbursement. For each gastrectomy patient, four comparisons were randomly selected from the pool of participants without gastrectomy and PLA at the baseline, frequency matched by the year of index date, age (every 5-year span), sex and comorbidity of diabetes (Fig. 2).

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’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.