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Pyogenic liver abscess in patients with inflammatory bowel disease: a nationwide cohort study
Background & Aims Pyogenic liver abscess (PLA) is a rare and severe extraintestinal complication in patients with inflammatory bowel disease (IBD). However, the incidence of PLA in patients with IBD remains unknown. Methods A nationwide cohort study was conducted by analysing data from the Natio...
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Published in: | Liver international 2016-01, Vol.36 (1), p.136-144 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Background & Aims
Pyogenic liver abscess (PLA) is a rare and severe extraintestinal complication in patients with inflammatory bowel disease (IBD). However, the incidence of PLA in patients with IBD remains unknown.
Methods
A nationwide cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. Patients with IBD (N = 11 504) from 2000 to 2010 and control participants without IBD (N = 46 016) were included in this study. We analysed the risks of PLA by using competing‐risks (death) regression models.
Results
The incidence of PLA was higher in the IBD cohort than in the control cohort (6.72 vs 4.06 per 10 000 person‐years), with an adjusted subhazard ratio (SHR) of 1.46 (95% confidence interval [CI], 1.01–2.12). Patients with IBD who required two or more hospitalizations per year and underwent laparotomy had an increased risk of PLA. Patients with ulcerative colitis were more likely to develop PLA than were those with Crohn's disease (incidence, 8.56 vs 5.45 per 10 000 person‐years; adjusted SHR, 1.65 vs 1.32). Among the IBD cohort, age and gender did not affect PLA risk. Patients with diabetes mellitus or percutaneous aspiration of the gallbladder and biliary tract and who underwent endoscopic insertion of a biliary drainage tube exhibited a significantly increased risk of PLA.
Conclusions
Patients with IBD exhibited an increased risk of developing PLA, particularly those with ulcerative colitis. Knowledge of the expected frequency and potential risk for this severe extraintestinal infection may minimize the serious consequences. |
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ISSN: | 1478-3223 1478-3231 |
DOI: | 10.1111/liv.12875 |