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Abstract
Background
The prevalence of pyogenic liver abscess (PLA) is increasing worldwide. However, evaluation on its economic burden is still lack.
Methods
A retrospective study that included all patients identified PLA from 2017 to 2020 was conducted. Clinical information and hospital costs were collected through the electronic medical records. We evaluated the economic burden using disability-adjusted life years (DALYs). Differences in socioeconomic burdens between Klebsiella pneumoniae-caused liver abscesses (KPLA) and non-Klebsiella pneumoniae-caused liver abscesses (non-KPLA) were compared.
Results
We found 327 patients identified PLA in the study, including 146 with KPLA and 181 with non-KPLA. The demographic characteristics, median hospital stay, severity, and in-hospital mortality were similar between the two groups. The median total in-hospital cost was higher in the non-KPLA than in the KPLA group, although no statistical difference was found ($3607.2 vs $3424.6; P = 0.446). The median DALY loss was significantly higher in the KPLA than in the non-KPLA group [1.49 (0.97–2.30) vs 1.27 (0.87–1.89); P = 0.033)], and male patients presented a higher average DALY loss than female patients. KPLA had a substantially greater median indirect economic loss than the non-KPLA group [$1442.8 (915.9–17,221.5) vs $1232.5 (764.6–15,473.0); P = 0.028], and indirect economic loss exhibited a significant increase from 2017 to 2020 in patients with PLA. No differences were found in the socioeconomic burden between the two groups [$8019.6 (4200.3–21,832.1) vs $7436.4 (4023.2–19,063.9); P = 0.172].
Conclusion
The economic burden of PLA is significant, particularly in patients with KP. Patients with KPLA experienced increased DALY loss and indirect economic loss than non-KPLA. PLA must be prioritized as the indirect economic burden rises annually.
Abbreviations
KP, Klebsiella pneumoniae; PLA, Pyogenic liver abscess; KPLA, Klebsiella pneumoniae-caused liver abscesses; ICU, Intensive care unit; DALY, Disability-adjusted life years; E. coli, Escherichia coli; GBD, Global Burden of Disease; CLSI, Clinical and Laboratory Standards Institute; APACHE, Acute Physiology and Chronic Health Evaluation; GDP, Gross domestic product; YLL, Years of life lost; YLD, Years lost due to disability; WHO, World Health Organization; IQR, Interquartile range; SD, Standard deviation; LOS, Length of stay; hvKP, hypervirulent Klebsiella pneumoniae; ESBL, Extended-spectrum beta-lactamase producing.
Data Sharing Statement
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. All patient data accessed complied with the relevant data protection and privacy regulations.
Acknowledgments
We would like to thank Tingting Xiao (First Affiliated Hospital, School of Medicine, Zhejiang University) for calculating the indirect economic loss. We also thank Home for Researchers editorial team for language editing service.
Author Contributions
All authors contributed significantly to the work reported, including conception, study design, execution, data acquisition, analysis, and interpretation, or all these areas; they have also written, revised, or critically reviewed the manuscript. They reviewed and consented to all versions of the manuscript before submission, gave final approval for the published version, agreed on the journal submission, and accepted responsibility for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.