Background: In viral hepatitis, an increase in the ratio of aspartate aminotransferase to alanine aminotransferase (AAR) is associated with poor prognosis. However, the relationship between AAR and pyogenic liver abscess (PLA) remains to be unclear. In this study, the relationship between AAR and adverse outcomes in PLA patients were explored, and the predictive value of AAR were evaluated.
Methods: In total, 240 PLA patients were consecutively enrolled in this study and followed up at 3 months. Univariate analysis, receiver-operating characteristic (ROC) curve analysis and multivariate logistic regression analyses were performed.
Results: According to the ROC curve of AAR for adverse outcomes, the patients were divided into two groups using a cutoff of 0.97. Patients with high AAR had higher risk of mortality rate (16.5% vs 2.9%), empyema (23.7% vs 10.4%), metastatic infection (19.1% vs 9.7%), acute myocardial (7.3% vs 0.7%), acute hepatic failure (7.3% vs 2.2%) and septic shock (13.7% vs 4.4%) than patients with low AAR (all P<0.05). after adjusting for potential confounding factors in our logistic model, high AAR was independently associated with death (odds ratio (OR)=6.17, 95% of confidence interval (CI)=1.88-20.26) and all adverse outcomes (OR=4.03, 95% CI=2.12-7.66). AAR had the largest area under ROC curve (AUC) than ALT, AST in all adverse outcomes (AUC=0.690, cutoff value=0.97, P<0.01) and death prediction (AUC=0.821, cutoff value=1.31, P<0.01).
Conclusion: In the clinical application of PLA, AAR may be a good method to predict the prognosis.