Independent prediction of aspartate aminotransferase to alanine aminotransferase ratio for adverse outcomes of patients with pyogenic liver abscess

Abstract Background: In viral hepatitis, an increase in the ratio of aspartate aminotransferase to alanine aminotransferase (AAR) is associated with poor prognosis. However, the relationship between AAR and pyogenic liver abscess (PLA) remains to be unclear. In this study, the relationship between AAR and adverse outcomes in PLA patients were explored, and the predictive value of AAR were evaluated. Methods: In total, 240 PLA patients were consecutively enrolled in this study and followed up at 3 months. Univariate analysis, receiver-operating characteristic (ROC) curve analysis and multivariate logistic regression analyses were performed. Results: According to the ROC curve of AAR for adverse outcomes, the patients were divided into two groups using a cutoff of 0.97. Patients with high AAR had higher risk of mortality rate (16.5% vs 2.9%), empyema (23.7% vs 10.4%), metastatic infection (19.1% vs 9.7%), acute myocardial (7.3% vs 0.7%), acute hepatic failure (7.3% vs 2.2%) and septic shock (13.7% vs 4.4%) than patients with low AAR (all P<0.05). after adjusting for potential confounding factors in our logistic model, high AAR was independently associated with death (odds ratio (OR)=6.17, 95% of confidence interval (CI)=1.88-20.26) and all adverse outcomes (OR=4.03, 95% CI=2.12-7.66). AAR had the largest area under ROC curve (AUC) than ALT, AST in all adverse outcomes (AUC=0.690, cutoff value=0.97, P<0.01) and death prediction (AUC=0.821, cutoff value=1.31, P<0.01). Conclusion: In the clinical application of PLA, AAR may be a good method to predict the prognosis.

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The AST/ALT (De Ritis) Ratio Independently Predicts Adverse Outcomes in Patients with Pyogenic Liver Abscess

10.21203/rs.3.rs-25277/v1 ◽

2020 ◽

Author(s):

Huifang Dai ◽

Jing Xu

Keyword(s):

Liver Abscess ◽

Roc Curve ◽

Univariate Analysis ◽

Acute Hepatic Failure ◽

Pyogenic Liver Abscess ◽

Adverse Outcomes ◽

Receiver Operating Curve ◽

Cutoff Value ◽

Metastatic Infection ◽

Receiver Operating

Abstract Background: An elevated aspartate aminotransaminase to alanine aminotransaminase ratio (AST/ALT) displays relationships to poor prognosis in viral hepatitis. However, the association between AST/ALT and pyogenic liver abscess (PLA) is unclear.Aim:This study delved into the relationships of AST/ALT and unfavorable results of PLA cases and ascertained AST/ALT predicting significance.Methods: In total, 240 PLA cases were consecutively recruited here and underwent a 3-month following-up. This study carried out receiver-operating characteristic (ROC) curve study, multiple-variate logistic regression analyses and univariate analysis.Results: In line with the receiver-operating curve of AST/ALT for unfavorable results, the cases fell to two subgroups with the use of a threshold of 0.97. Cases with high AST/ALT had higher risk of mortality (16.5% vs 2.9%), metastatic infection (19.1% vs 9.7%), acute hepatic failure (7.3% vs 2.2%), acute myocardial (7.3% vs 0.7%), empyema (23.7% vs 10.4%) and septic shock (13.7% vs 4.4%) than cases with low AST/ALT (all P < 0.05). after adjusting for potential confounders in our logistic model, high AST/ALT was independently associated with all unfavorable results (OR = 4.03, 95% CI = 2.12–7.66) and death (odds ratio (OR) = 6.17, 95% of confidence interval (CI) = 1.88–20.26). AST/ALT exhibited the widest area underneath ROC curve (AUC) as compared with AST, ALT in death prediction (AUC = 0.821, cutoff value = 1.31, P < 0.01) and overall unfavorable results (AUC = 0.690, cutoff value = 0.97, P < 0.01).Conclusion: AST/ALT may be a good candidate for predicting prognosis in future clinical practice of PLA.

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The geriatric nutritional risk index independently predicts adverse outcomes in patients with pyogenic liver abscess

BMC Geriatrics ◽

10.1186/s12877-019-1030-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 8

Author(s):

Jing Xu ◽

Xinhe Zhou ◽

Chao Zheng

Keyword(s):

Liver Abscess ◽

Risk Index ◽

Pyogenic Liver Abscess ◽

Adverse Outcomes ◽

Nutritional Risk ◽

Geriatric Nutritional Risk Index ◽

Nutritional Risk Index

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Genomic Heterogeneity inKlebsiella pneumoniaeStrains Is Associated with Primary Pyogenic Liver Abscess and Metastatic Infection

The Journal of Infectious Diseases ◽

10.1086/430619 ◽

2005 ◽

Vol 192 (1) ◽

pp. 117-128 ◽

Cited By ~ 104

Author(s):

Li‐Chen Ma ◽

Chi‐Tai Fang ◽

Cha‐Ze Lee ◽

Chia‐Tung Shun ◽

Jin‐Town Wang

Keyword(s):

Liver Abscess ◽

Pyogenic Liver Abscess ◽

Metastatic Infection

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Predictive Value of Aspartate Aminotransferase to Alanine Aminotransferase Ratio for Hepatic Fibrosis and Clinical Adverse Outcomes in Patients With Primary Biliary Cirrhosis

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0b013e31818980ac ◽

2009 ◽

Vol 43 (9) ◽

pp. 876-883 ◽

Cited By ~ 16

Author(s):

Chien-Wei Su ◽

Che-Chang Chan ◽

Hung-Hsu Hung ◽

Teh-Ia Huo ◽

Yi-Hsiang Huang ◽

...

Keyword(s):

Primary Biliary Cirrhosis ◽

Hepatic Fibrosis ◽

Predictive Value ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Adverse Outcomes ◽

Biliary Cirrhosis

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Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

Journal of International Medical Research ◽

10.1177/0300060518781256 ◽

2018 ◽

Vol 46 (9) ◽

pp. 3824-3836 ◽

Cited By ~ 4

Author(s):

Jing Chen ◽

Minwei Zhang ◽

Jinlong Chen ◽

Yaogui Ning ◽

Xiaoyang Cai ◽

...

Keyword(s):

Liver Abscess ◽

Multivariate Logistic Regression Analysis ◽

Pyogenic Liver Abscess ◽

Tertiary Hospital ◽

Microbial Infection ◽

Theoretical Support ◽

Metastatic Infection ◽

Infectious Origin ◽

Male Sex ◽

Different Characteristics

Objective To enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic). Methods This retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics. Results In all, 178 patients were included: 111 cases (62.4%) of cryptogenic PLA, and 67 cases (37.6%) of non-cryptogenic PLA. Diabetes mellitus was significantly more prevalent in patients with cryptogenic PLA than those with non-cryptogenic PLA. The proportion of multidrug resistance/poly-microbial infection was significantly lower and Klebsiella pneumoniae infection was significantly higher in the cryptogenic versus non-cryptogenic PLA group. Metastatic infection occurred in four patients with cryptogenic PLA only, and all had diabetes and K. pneumoniae infection. Multivariate logistic regression analysis revealed that male sex, diabetes and K. pneumoniae were independent predictors for cryptogenic PLA. Conclusions Cryptogenic and non-cryptogenic PLA have distinctly different characteristics, suggesting a potential need for different treatment approaches.

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The Role of Red Blood Cell Distribution Width in the Severity and Prognosis of Community-Acquired Pneumonia

Canadian Respiratory Journal ◽

10.1155/2021/8024024 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Qiang Ren ◽

Hebing Liu ◽

Ying Wang ◽

Deyu Dai ◽

Zhennan Tian ◽

...

Keyword(s):

Roc Curve ◽

Inflammatory Markers ◽

Operating Characteristic ◽

White Blood Cells ◽

Community Acquired Pneumonia ◽

Adverse Outcomes ◽

Distribution Width ◽

Reactive Protein ◽

The Relationship

Objectives. The objective of this study is to unravel the correlation between RDW and the severity and prognosis of CAP, as well as exploring RDW with the inflammatory markers white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Methods. According to the data characteristics, appropriate statistical methods were selected to analyze the relationship between RDW and the severity and prognosis of CAP patients and to determine whether RDW is associated with the inflammatory markers WBC, CRP, and PCT. Results. The results show that with the increase of PSI and CURB-65 values, the proportion of patients with RDW ≥ 12.987% is significantly higher than that of RDW < 12.987% ( P < 0.01 ). When RDW is combined with PSI or CURB-65 to predict the 90-day mortality of CAP patients, the area under the receiver operating characteristic (ROC) curve increased prominently, and if RDW, PSI, and CURB-65 are combined, the area under the ROC curve is maximized. Conclusions. Our findings suggest that the higher RDW value is associated with short-term adverse outcomes in CAP patients. We also find that when RDW, PSI, and CURB-65 are combined, the best performance is achieved to predict CAP 90-day mortality risk.

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Pyogenic Liver Abscess: Does Escherichia Coli Cause more Adverse Outcomes than Klebsiella Pneumoniae?

World Journal of Surgery ◽

10.1007/s00268-015-3126-1 ◽

2015 ◽

Vol 39 (10) ◽

pp. 2535-2542 ◽

Cited By ~ 28

Author(s):

Vishal G. Shelat ◽

Clement L. K. Chia ◽

Charleen S. W. Yeo ◽

Wang Qiao ◽

Winston Woon ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Pyogenic Liver Abscess ◽

Adverse Outcomes

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Eating quickly is associated with a low aspartate aminotransferase to alanine aminotransferase ratio in middle-aged adults: a large-scale cross-sectional survey in Japan

Archives of Public Health ◽

10.1186/s13690-020-00482-3 ◽

2020 ◽

Vol 78 (1) ◽

Author(s):

Eri Ozaki ◽

Hirotaka Ochiai ◽

Takako Shirasawa ◽

Takahiko Yoshimoto ◽

Satsue Nagahama ◽

...

Keyword(s):

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Fatty Liver Disease ◽

Large Scale ◽

Middle Aged ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Nonalcoholic Fatty Liver ◽

Middle Aged Adults ◽

The Relationship

Abstract Background An elevated alanine aminotransferase (ALT) and a low aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) suggest nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, increasing the risk of liver cirrhosis and hepatocellular carcinoma. In addition, eating quickly has been found to be associated with outcomes such as obesity. This study sought to investigate the relationship between eating quickly and an elevated ALT or a low AST/ALT ratio in Japanese middle-aged adults. Methods The present study included 283,073 adults aged 40–64 years who had annual health checkups in Japan from April 2013 to March 2014. The data of serum parameters and lifestyle factors, including eating speed, were analyzed. An elevated ALT was defined as > 40 U/L, and a low AST/ALT ratio was defined as < 1. Logistic regression analysis was performed to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs) for an elevated ALT and a low AST/ALT ratio. Results Significantly increased ORs for an elevated ALT were observed in men (OR: 1.45, 95% CI: 1.41–1.49) and women (OR: 1.34, 95% CI: 1.25–1.43). Moreover, eating quickly significantly increased the ORs for a low AST/ALT ratio in men (OR: 1.53, 95% CI: 1.50–1.56) and women (OR: 1.36, 95% CI: 1.31–1.41). When the analysis was limited to those with ALT ≤40 U/L, eating quickly had significantly increased ORs for a low AST/ ALT ratio, regardless of sex. Conclusions Eating quickly was significantly associated with an elevated ALT and a low AST/ALT ratio. In addition, eating quickly was significantly associated with a low AST/ALT ratio even for those without ALT elevation. This study suggested that modification of eating speed may contribute to reducing the risk for an elevated ALT and a low AST/ALT ratio.

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