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The following is a summary of “Prognosis of liver abscess in the intensive care unit (POLAIR), a multicentre observational study,” published in the April 2025 issue of Critical Care by Goff et al. 

Researchers conducted a retrospective study to examine epidemiological data and outcomes of individuals with liver abscess (LA) requiring intensive care unit (ICU) admission.  

They analyzed data from adults admitted to 24 ICUs in France between January 2010 and December 2020. Risk factors for mortality were determined using multivariate analysis. A propensity score was adjusted for confounders associated with portal vein thrombosis (PVT).  

The results showed that 335 individuals were enrolled, with a median age of 66 years [53–73], and 68% were male. Common comorbidities included diabetes (29.9%) and cancer or hematological disease. Septic shock accounted for 58% of ICU admissions. The median Simplified Acute Physiology Score II (SAPS2) was 42 [31–53], and the Sequential Organ Failure Assessment (SOFA) score was 6 [3–9]. The LA had a biliary origin in 31% of cases, while 40% were cryptogenic. Solitary abscesses were observed in 60%, with the right lobe affected in 38.8% and a median diameter of 67 mm [47–91], PVT was present in 13.4% of cases. Microbiological documentation was obtained in 82%, revealing gram-negative bacilli (59.7%), primarily Escherichia coli (19.6%) and Klebsiella spp. (19.1%), and gram-positive cocci (29.6%), mainly Streptococcus spp. (17.1%). Drainage was performed in 62% of cases, with 40% undergoing the procedure within 48 hours. The median duration of antibiotic therapy was 35 days [21–42]. During hospitalization, 62% required vasopressors, and 29% needed mechanical ventilation. In-ICU mortality was 11.6%. Multivariate analysis identified organ dysfunction, represented by SOFA score (hazard ratio [HR] 3.45 [1.95–6.09], P < 0.001), and PVT (HR 3.14 [1.54–6.39], P = 0.001) as significant mortality risk factors. Drainage did not improve short-term survival (HR 1.22 [0.65–2.72], P = 0.52). In the population matched for PVT confounders, a higher SOFA score remained the only mortality-associated factor (HR 3.11 [1.76–5.49] IC95%, P = 0.001).  

Investigators concluded that the severity of LA correlated with organ dysfunction SOFA score and PVT as key mortality risk factors, and the benefit of drainage required further prospective investigation. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05376-w