2010 Jun - Review of Lung Abscess Manifestations in a Local Hospital: A 10-year retrospective study
Dr. AU Ka Fai, Kwong Wah Hospital
The aim of this study is to review the clinical manifestations of lung abscess in a local hospital and to find out associated risk factors for poor clinical outcome.
A retrospective study review was performed on all the lung abscess cases admitted from January 2000 to December 2009 in Kwong Wah Hospital.
A total of 66 patients were recruited for analysis with a mean age of 58 ± 17 (range: from 26 to 92 years old). About two-thirds of them were smokers. Male patients were predominant. Primary lung abscess accounted for 68% of all cases. The all-cause mortality was 24%. Only 2 patients required surgical interventions, while medical therapy +/- percutaneous tube drainage was the treatment modality for others. Streptococcus milleri was the commonest causative pathogen cultured from the pus aspirate (8 out of 22 specimens) instead of anaerobes. With univariate analysis, old age home resident (p=0.039), requiring oxygen supplement (p=0.017), on mechanical ventilator support (p=0.002), secondary lung abscess (p=0.016), high urea (p=0.026) and low albumin level (p<0.001) were factors associated with higher all-cause-mortality.
The incidence of lung abscess was declining with time. However, it had still led to a high all-cause mortality rate of 24%. Anaerobic microbials were not the most commonly found causative pathogens, which might reflect a change in the bacteriology of lung abscess. Old age home resident, oxygen supplement, mechanical ventilator support, secondary lung abscess, high urea and low albumin level were the factors related to poor clinical outcome. Medical therapy was the effective treatment for most cases.