BACKGROUND The aim of this study was to investigate the clinical manifestation and predictive risk factors of pleural empyema developing during treatment of the pyogenic liver abscess. METHODS Medical records of patients with the liver abscess in our institution were reviewed retrospectively. Enrolled patients were classified into four groups; Group 1: patients without pleural effusion, Group 2: patients with pleural effusion and who were treated noninvasively, Group 3: patient with pleural effusion and who were treated with thoracentesis, and Group 4: patients with pleural effusion that developed into empyema. Patient characteristics, clinical manifestation, and possible risk factors in development of empyema were analyzed. RESULTS A total of 234 patients was enrolled in this study. The incidence rate of empyema was 4.27% (10 patients). The mean interval for developing pleural effusion was 5.6 ± 6.35 days. In multivariate analysis, risk factors for developing pleural effusion included the location of the liver abscess near the right diaphragm (segment 7 and 8, OR = 2.30, p = 0.048), and larger diameter of the liver abscess (OR = 1.02, p = 0.042). Among patients who developed pleural effusions, presences of mixed microorganisms from culture of liver aspirates (OR = 10.62, p = 0.044), bilateral pleural effusion (OR = 46.72, p = 0.012) and combined biliary tract inflammation (OR = 21.05, p = 0.040) were significantly associated with the need for invasive intervention including surgery on effusion. CONCLUSION The location of the liver abscess as well as pleural effusion, elevated inflammatory markers, and combined biliary tract inflammation may be important markers of developing pleural complication in patients with pyogenic liver abscess.

中文翻译：

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肝脓肿继发胸膜积脓的临床危险因素评估。

背景技术本研究的目的是研究化脓性肝脓肿治疗期间胸膜积脓发展的临床表现和预测危险因素。方法回顾性分析我院肝脓肿患者的病历。入组患者分为四组：第1组：无胸腔积液的患者，第2组：有胸膜积液且无创治疗的患者，第3组：有胸膜积液且接受胸腔穿刺治疗的患者，第4组：发展为脓胸的胸膜积液的患者。分析了脓胸发展过程中的患者特征，临床表现和可能的危险因素。结果本研究共纳入234例患者。脓胸的发生率为4.27％（10例患者）。发生胸腔积液的平均间隔为5.6±6.35天。在多变量分析中，发生胸腔积液的危险因素包括肝脓肿在右diaphragm肌附近的位置（第7和8段，OR = 2.30，p = 0.048）和较大的肝脓肿直径（OR = 1.02，p = 0.042）。在发生胸腔积液的患者中，存在来自肝抽吸物的混合微生物（OR = 10.62，p = 0.044），双侧胸腔积液（OR = 46.72，p = 0.012）和合并的胆道炎症（OR = 21.05，p = 0.040）与包括浸润手术在内的侵入性干预需求显着相关。结论肝脓肿的位置以及胸腔积液，炎症标志物升高，