Pyogenic Liver Abscess Correlates With Increased Risk of Acute Pancreatitis: A Population-Based Cohort Study

BACKGROUND The aim of this study was to explore whether there is a relationship between pyogenic liver abscess (PLA) and subsequent risk of acute pancreatitis in Taiwan. METHODS Using inpatients claims data from the Taiwan National Health Insurance Program, we identified 30 866 subjects aged 20-84 years with the first-attack of PLA from 2000 to 2010 as the PLA group and randomly selected 123 464 subjects without PLA as the non-PLA group. The incidence of the first attack of acute pancreatitis at the end of 2010 and the risk associated with PLA and other comorbidities were measured. RESULTS The overall incidence of acute pancreatitis was 3.84-fold greater in the PLA group than in the non-PLA group (4.61 vs 1.19 events per 1000 person-years; 95% CI, 3.43-4.29). After controlling for potential confounding factors, the adjusted hazard ratio of acute pancreatitis was 3.00 (95% CI, 2.62-3.43) for the PLA group, as compared to the non-PLA group. Further analysis showed that compared to subjects with neither PLA nor comorbidities, patients with PLA and hypertriglyceridemia, biliary stones, alcoholism, or hepatitis C had greater risk of acute pancreatitis than those with PLA alone. CONCLUSIONS PLA correlates with increased risk of subsequent acute pancreatitis. Comorbidities, including hypertriglyceridemia, biliary stones, alcoholism, and hepatitis C, may enhance the risk of developing acute pancreatitis.