Clinical Report: Enhancing Healthcare Resource Management in Pyogenic Liver Abscess

Overview

This study identifies admission high-density lipoprotein cholesterol (HDL-C) as a predictor of hospital stay duration in patients with pyogenic liver abscess (PLA). A dual-threshold model combining HDL-C and C-reactive protein (CRP) effectively flags patients at risk for prolonged hospitalization.

Background

Pyogenic liver abscess (PLA) is a significant intra-abdominal infection associated with high morbidity and prolonged hospital stays. Identifying patients at risk for extended hospitalization can enhance resource management and improve patient outcomes. Current clinical tools for predicting hospitalization duration are limited, highlighting the need for effective biomarkers like HDL-C.

Data Highlights

Key Findings

• Lower HDL-C levels are independently associated with longer hospital stays in PLA patients.
• A dual-threshold of HDL-C < 1.03 mmol/L and CRP > 1.0 mg/dL identifies a high-risk subgroup for prolonged hospitalization.
• The nomogram combining HDL-C, abscess size, and sepsis shows good predictive performance.
• CRP mediates a small proportion of the association between HDL-C and length of stay.
• Findings were validated across multiple external datasets, indicating generalizability.

Clinical Implications

Clinicians should consider admission HDL-C and CRP levels when assessing PLA patients to identify those at risk for prolonged hospitalization. Early identification may facilitate closer monitoring and timely interventions, potentially improving patient outcomes and resource allocation.

Conclusion

The study underscores the utility of admission HDL-C and CRP in predicting hospitalization duration for PLA patients, advocating for their integration into clinical practice for better resource management.

References

1. IDSA 2024 Guideline Update on the Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation of Complicated Intra-abdominal Infections in Adults, Children, and Pregnant People
2. Short versus long-course antibiotic therapy for pyogenic liver abscess: an emulated target trial - PubMed
3. Surgical Endoscopy — Factors Influencing Positive Bile Cultures: Development of a Predictive Model and Evaluation of Diagnostic Test Accuracy
4. A New Predictive Model for Bloodstream Infections in Patients Undergoing Hepatobiliary and Pancreatic Surgery
5. European Radiology — Prognostic Value of Dual-Energy CT Liver Fat Fraction in Critically Ill Patients
6. Infection — Development of a Predictive Model for Bacterial Co-Infections in COVID-19 Hospitalized Patients: Findings from a Multicenter Observational Study
7. IDSA 2024 Guideline Update on the Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation of Complicated Intra-abdominal Infections in Adults, Children, and Pregnant People
8. Short versus long-course antibiotic therapy for pyogenic liver abscess: an emulated target trial - PubMed
9. Frontiers | An individualized nomogram for predicting risk of sepsis in patients with pyogenic liver abscesses: a 10 years retrospective analysis