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European Radiology

, Volume 24, Issue 5, pp 980–989 | Cite as

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

  • Hong-Hau Wang
  • Shih-Hung Tsai
  • Chih-Yung Yu
  • Hsian-He Hsu
  • Chang-Hsien Liu
  • Jung-Chung Lin
  • Guo-Shu Huang
  • Wei-Tung Cheng
  • Ho-Jui Tung
  • Ching-Yang Chen
  • Wei-Chou ChangEmail author
Computed Tomography

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.

Keywords

Klebsiella pneumoniae liver abscess Haemoglobin A1C Diabetes mellitus Computed tomography Semiautomated volumetric analysis 

Abbreviations

KPLA

Klebsiella pneumoniae liver abscesses

DM

diabetes mellitus

HbA1C

haemoglobin A1C

PCD

percutaneous catheter drainage

Notes

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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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Hong-Hau Wang
    • 1
    • 2
  • Shih-Hung Tsai
    • 3
  • Chih-Yung Yu
    • 1
  • Hsian-He Hsu
    • 1
  • Chang-Hsien Liu
    • 1
  • Jung-Chung Lin
    • 4
  • Guo-Shu Huang
    • 1
  • Wei-Tung Cheng
    • 2
  • Ho-Jui Tung
    • 5
  • Ching-Yang Chen
    • 2
  • Wei-Chou Chang
    • 1
    Email author
  1. 1.Department of RadiologyTri-Service General Hospital, National Defense Medical CenterTaipeiTaiwan, Republic of China
  2. 2.Department of RadiologyTri-Service General Hospital Songshan Branch. National Defense Medical CenterTaipeiTaiwan, Republic of China
  3. 3.Department of Emergency MedicineTri-Service General Hospital, National Defense Medical CenterTaipeiTaiwan, Republic of China
  4. 4.Division of Infectious Diseases and Tropical Medicine, Department of Internal MedicineTri-Service General Hospital, National Defense Medical CenterTaipeiTaiwan, Republic of China
  5. 5.Department of Healthcare AdministrationAsia UniversityTaichungTaiwan, Republic of China

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