Predictive factors for clinical resolution and the impact of metabolic comorbidities in adult liver abscesses: A prospective study

Abstract

Background: Percutaneous drainage has transformed hepatic abscess management, yet recovery trajectories remain heterogeneous. While procedural success is high, the pace of clinical resolution is dictated more by the host environment than by technical factors. Aims and Objectives: The aim of the study was to identify baseline predictors – C-reactive protein (CRP), glycemic status, and hemoglobin (Hb) levels – that influence time to clinical relief and hospital stay in patients undergoing percutaneous intervention for liver abscess. Materials and Methods: A prospective observational study of 36 patients with radiologically confirmed hepatic abscesses was conducted at a tertiary care center in Eastern India. Host-specific variables, including diabetes mellitus, anemia (Hb <10 g/dL), and high inflammatory burden (CRP >30 mg/L), were correlated with outcomes: time to apyrexia and duration of hospitalization. Results: The cohort demonstrated marked systemic inflammation (86% with total leukocyte count >11,000 cells/mm3). Diabetic patients had significantly delayed recovery, with a mean time to apyrexia of 5.8±1.2 days versus 3.2±0.8 days in non-diabetics (P=0.041). Anemia was strongly associated with prolonged hospital stay, with 81% requiring >10 days for stabilization (P=0.029). Elevated baseline CRP (>30 mg/L) was a robust predictor of extended hospitalization (P=0.0003), independent of drainage modality. Conclusion: Host metabolic and inflammatory milieu is a superior determinant of clinical resolution compared to procedural choice. Hyperglycemia and anemia impair parenchymal healing and prolong systemic inflammation. Risk stratification using baseline CRP, Hb, and glycemic status is essential for personalized management and resource optimization in liver abscess care.