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• W4296475477 abstract "<h3>Background</h3> Pyogenic liver abscess is a rare diagnosis but rates appear to be rising in western settings. The clinical picture and available management options have evolved significantly in recent decades with biliary aetiology dominating, and prolonged antibiotic therapy and percutaneous drainage now the mainstay of treatment. However comprehensive guidelines for best-practice management and an evidence-base is lacking. <h3>Methods</h3> This paper describes all cases of liver abscess presenting to a tertiary referral hospital between 2015 and 2020 in terms of patient characteristics, presenting features, aetiology, and management. Multiple regression analysis is used to evaluate the effect of percutaneous abscess drainage and management under an outpatient parenteral antibiotic therapy service on survival and inpatient duration. <h3>Results</h3> 115 cases of liver abscess are described giving a crude annual incidence of 7.0 per 100 000 population. The population described is older and has more associated comorbidity and malignancy than other centres, with a correspondingly higher mortality. Evidence of severe dysregulated immune response at presentation is described in most patients. As widely described, biliary aetiology is the dominant origin of liver abscess in this cohort but microbiological aetiology varies from centre to centre. There was no detectable difference in outcomes in patients managed with and without percutaneous abscess drainage after adjusting for possible confounders (p=0.962, p=0.954, p=0.339 for 6 week survival, 6 month survival and inpatient duration respectively). There was a trend towards improved survival in those who were managed under an outpatient parenteral antibiotic therapy service (OR 3.17, 95%CI 1.10–10.3 for 6 week survival; Odds Ratio 2.29, 95%CI 0.89–6.30 for 6 month survival). <h3>Conclusion</h3> This study illustrates the heterogeneity of liver abscess in the UK in terms of patient characteristics, clinical presentation, aetiology and management. It highlights the lack of an evidence-base to guide management of liver abscess. <h3>References</h3> Mohsen AH, Green ST, Read RC, McKendrick MW. Liver abscess in adults: ten years experience in a UK centre. <i>QJM</i>. 2002 Dec;<b>95</b>(12):797–802. Ko M-C, Lin W-H, Martini S, Chang Y-H, Chiu C-T, Li C-Y. A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus. <i>Medicine (Baltimore)</i>. 2019 Apr;<b>98</b>(17):e15366. Tan Y-M, Chung AY-F, Chow PK-H, Cheow P-C, Wong W-K, Ooi LL, <i>et al</i>. 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• W4296475477 title "P47 Presentation, management, and outcomes of pyogenic liver abscess in a single UK centre: a comparison between centres and an evaluation of liver abscess management" @default.
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