Amebic liver abscess hospitalizations in the United States: A nationwide analysis of trends and severe morbidity, 2002-2023

Document Type

Article

Publication Date

10-1-2026

Publication Title

Clin Res Hepatol Gastroenterol

Keywords

Humans, Liver Abscess, Amebic, United States, Male, Retrospective Studies, Female, Cross-Sectional Studies, Hospitalization, Adult, Middle Aged, Severity of Illness Index, Aged

Abstract

AIMS: US population-based data on amebic liver abscess (ALA) are limited and predate the ICD-10-CM era. We quantified national trends, inpatient outcomes, and factors associated with severe in-hospital morbidity among adult ALA hospitalizations.

METHODS AND RESULTS: We performed a retrospective cross-sectional analysis of the 2002-2023 National Inpatient Sample, excluding 2015. ALA was identified by ICD-9-CM 006.3 or ICD-10-CM A06.4 in any diagnosis position. The primary morbidity outcome was a composite of severe sepsis, acute kidney injury, liver-related decompensation, gram-negative septicemia, or unspecified septicemia. Survey-weighted analyses incorporated discharge weights, strata, and clustering. We identified 688 ALA hospitalizations, representing 3314 weighted national hospitalizations (95% CI, 2982-3646). The annual proportion declined (P < 0.001). ALA hospitalizations were predominantly male (77.6%), frequently Hispanic (51.7%), and concentrated in the West (45.6%). A coded drainage/aspiration procedure was present in 57.2%. The severe morbidity composite occurred in 25.1% of ALA versus 15.1% of general adult hospitalizations (P < 0.001). Mean length of stay (8.64 vs 4.83 days) and mean 2023 charges ($82,964 vs $55,508) were higher (both P < 0.001). Coagulopathy was the only factor retained after backward elimination (adjusted OR, 3.82; 95% CI, 1.49-9.77; P = 0.006), but final-model discrimination was poor (c-statistic, 0.560).

CONCLUSION: ALA remains a rare but high-morbidity coded inpatient diagnosis in the United States. Administrative variables did not yield a clinically useful individual-level risk prediction model.

Medical Subject Headings

Humans; Liver Abscess, Amebic; United States; Male; Retrospective Studies; Female; Cross-Sectional Studies; Hospitalization; Adult; Middle Aged; Severity of Illness Index; Aged

PubMed ID

42716300

Volume

50

Issue

8

First Page

102912

Last Page

102912

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