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The association of haemoglobin A1C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus

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Abstract

Objectives

To compare the characteristics of Klebsiella pneumoniae liver abscesses (KPLA) in diabetic patients with different levels of glycaemic control.

Methods

The institutional review board approved this retrospective study. A total of 221 patients with KPLA were included. Clinical features of KPLA were compared. We divided the 120 diabetic patients with KPLA into three subgroups based on haemoglobin A1C (HbA1C) concentration (good, HbA1C ≤ 7.0 %; suboptimal, 7.0 % < HbA1C ≤ 9.0 %; poor, HbA1C > 9.0 %). In this study, we used a semiautomated quantitative method to assess the gas and total abscess volumes in KPLA. Statistical analysis was performed with the chi-squared test and one-way analysis of variance.

Results

The mortality rate did not significantly differ between the nondiabetic and diabetic groups. However, patients with poor glycaemic control had significantly more complications and therefore a longer hospital stay (P < 0.05). In our study, CT and quantitative analyses found that patients in the group with poor glycaemic control had a significantly higher incidence of gas formation and hepatic venous thrombophlebitis and a higher gas-to-abscess volume ratio than patients with suboptimal and good glycaemic control (P < 0.05).

Conclusions

Diabetic patients with a high HbA1C concentration (>9.0 %) have an association with hepatic venous thrombophlebitis, gas formation and metastatic infection complications associated with KPLA.

Key Points

• Poorly controlled diabetes is associated with complications in Klebsiella pneumoniae liver abscesses.

• Hepatic venous thrombosis and gas are important signs of metastatic infection.

• Hepatic venous thrombophlebitis is associated with 72.7 % of metastatic infections.

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Abbreviations

KPLA:

Klebsiella pneumoniae liver abscesses

DM:

diabetes mellitus

HbA1C :

haemoglobin A1C

PCD:

percutaneous catheter drainage

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Acknowledgements

We would like to give special thanks to Benjamin Yeh of the University of California, San Francisco, for his guidance and help.

The scientific guarantor of this publication is Wei-Chou Chang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The study was supported by the Tri-Service General Hospital Research Grant (TSGH-C101-053) and approved by the Tri-Service General Hospital Institutional Review Board (TSGHIRB-2-101-05-119). Ho-Jui Tung kindly provided statistical advice for this manuscript. He is one of the authors with significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Hong-Hau Wang, Chih-Yung Yu, Hsian-He Hsu, Chang-Hsien Liu, Guo-Shu Huang & Wei-Chou Chang

  2. Department of Radiology, Tri-Service General Hospital Songshan Branch. National Defense Medical Center, Taipei, Taiwan, Republic of China

    Hong-Hau Wang, Wei-Tung Cheng & Ching-Yang Chen

  3. Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Shih-Hung Tsai

  4. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Jung-Chung Lin

  5. Department of Healthcare Administration, Asia University, Taichung, Taiwan, Republic of China

    Ho-Jui Tung

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  1. Hong-Hau Wang
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Correspondence to Wei-Chou Chang.

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Wang, HH., Tsai, SH., Yu, CY. et al. The association of haemoglobin A1C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus. Eur Radiol 24, 980–989 (2014). https://doi.org/10.1007/s00330-014-3113-1

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  • DOI: https://doi.org/10.1007/s00330-014-3113-1

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