Increased risk and case fatality rate of pyogenic liver abscess in patients with liver cirrhosis: A nationwide study in Denmark

Background-Patients with liver cirrhosis are at increased risk of serious b acterial infections carrying a high case fatality rate. Case reports associ ation between liver cirrhosis and pyogenic liver abscess. Aims-To estimate the risk and case fatality rate of pyogenic liver abscess in Danish patients with liver cirrhosis compared with the background popula tion. Methods-Identification of all patients with liver cirrhosis and pyogenic li ver abscess over a 17 year period in the National Registry of Patients. Inf ormation on death was obtained from the Danish Central Person Registry. Results-We identified 22 769 patients with liver cirrhosis and 665 patients with pyogenic liver abscess, of whom 21 were cirrhotics and 644 were non-c irrhotics. The crude incidence rate of liver abscess in cirrhotics was 23.3 (95% CI 14.4-35.6) per 100 000 person years. The age adjusted risk of live r abscess was increased 15-fold in patients with cirrhosis compared with th e background population. The 30 day case fatality rates in patients with li ver abscess and cirrhosis were 38.5% (13.9-68.4) in alcoholic cirrhosis and 62.5% (24.5-91.5) in non-alcoholic cirrhosis compared with 26.9% (23.5-30. 5) in liver abscess patients from the background population. After adjustme nt for sex, age, and comorbidity, the relative risk of death was increased more than fourfold in alcoholic cirrhosis and non-alcoholic cirrhosis compa red with the background population. Conclusions-Liver cirrhosis is a strong risk factor for pyogenic liver absc ess associated with a poor prognosis.