{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:11Z","timestamp":1787027351059,"version":"build-2736575974"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>\n                    Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. Serum albumin\/globulin ratio (AGR) can reflect the progress of many diseases. However, the clinical significance of AGR in PLA has not been evaluated. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The medical records on admission were collected. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The mean level of AGR in PLA patients was 1.02 \u00b1 0.25. There were 179 (45.4%) patients with AGR &amp;gt; 1.02 and 213 (54.6%) patients with AGR \u2264 1.02. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , and were more susceptible to multiple bacteria. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. And it also needs longer time for temperature normalization and hospital stay. In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients.\n                  <\/jats:p>","DOI":"10.3389\/fsurg.2021.677799","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T10:32:09Z","timestamp":1638354729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":36,"title":["Clinical Significance of Serum Albumin\/Globulin Ratio in Patients With Pyogenic Liver Abscess"],"prefix":"10.3389","volume":"8","author":[{"given":"Jia","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengzhou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junzhou","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongqian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/S0163-4453(83)95356-2","article-title":"Pyogenic liver abscess","volume":"6","author":"Chattopadhyay","year":"1983","journal-title":"J Infect."},{"key":"B2","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.jmii.2014.08.028","article-title":"Epidemiology and clinical outcome of pyogenic liver abscess: an analysis from the national health insurance research database of Taiwan, 2000-2011","volume":"49","author":"Chen","year":"2016","journal-title":"J Microbiol Immunol Infect."},{"key":"B3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12877-019-1030-5","article-title":"The geriatric nutritional risk index independently predicts adverse outcomes in patients with pyogenic liver abscess","volume":"19","author":"Xu","year":"2019","journal-title":"BMC Geriatr."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1086\/513201","article-title":"Diabetes mellitus and pyogenic liver abscess: risk and prognosis","volume":"44","author":"Thomsen","year":"2007","journal-title":"Clin Infect Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12879-020-4855-9","article-title":"Effect of diabetes mellitus on short-term prognosis of 227 pyogenic liver abscess patients after hospitalization","volume":"20","author":"Du","year":"2020","journal-title":"BMC Infect Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1756-0500-4-80","article-title":"Modern management of pyogenic hepatic abscess: a case series and review of the literature","volume":"4","author":"Heneghan","year":"2011","journal-title":"BMC Res Notes."},{"key":"B7","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/S0002-9610(00)00564-X","article-title":"Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess","volume":"181","author":"Alvarez Perez","year":"2001","journal-title":"Am J Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1681\/ASN.2009020213","article-title":"Reassessment of albumin as a nutritional marker in kidney disease","volume":"21","author":"Friedman","year":"2010","journal-title":"J Am Soc Nephrol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1177\/0884533613486297","article-title":"Commonly used \u201cnutrition\u201d indicators do not predict outcome in the critically ill: a systematic review","volume":"28","author":"Ferrie","year":"2013","journal-title":"Nutr Clin Pract."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1177\/000313481708301123","article-title":"Hypoalbuminemia and clinical outcomes: what is the mechanism behind the relationship?","volume":"83","author":"Kim","year":"2017","journal-title":"Am Surg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3390\/nu10010017","article-title":"Potential role of amino acid\/protein nutrition and exercise in serum albumin redox state","volume":"10","author":"Wada","year":"2017","journal-title":"Nutrients"},{"key":"B12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1177\/0148607112445900","article-title":"Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review","volume":"37","author":"Van Stijn","year":"2013","journal-title":"JPEN J Parenter Enteral Nutr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1016\/j.arth.2019.02.003","article-title":"Prognostic role of serum albumin, total lymphocyte count, and mini nutritional assessment on outcomes after geriatric hip fracture surgery: a meta-analysis and systematic review","volume":"34","author":"Li","year":"2019","journal-title":"J Arthroplasty."},{"key":"B14","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.cca.2012.01.021","article-title":"Low serum sex hormone-binding globulin: marker of inflammation?","volume":"413","author":"Liao","year":"2012","journal-title":"Clin Chim Acta."},{"key":"B15","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1530\/JOE-16-0047","article-title":"Corticosteroid-binding globulin is a biomarker of inflammation onset and severity in female rats","volume":"230","author":"Hill","year":"2016","journal-title":"J Endocrinol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1055\/s-0042-108071","article-title":"Corticosteroid-Binding globulin: a review of basic and clinical advances","volume":"48","author":"Meyer","year":"2016","journal-title":"Horm Metab Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1161\/01.STR.24.8.1133","article-title":"Fibrinogen and the albumin-globulin ratio in recurrent stroke","volume":"24","author":"Beamer","year":"1993","journal-title":"Stroke."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e022960","DOI":"10.1136\/bmjopen-2018-022960","article-title":"Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China","volume":"8","author":"Li","year":"2018","journal-title":"BMJ Open."},{"key":"B19","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.cca.2017.11.019","article-title":"Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: a meta-analysis","volume":"476","author":"Lv","year":"2018","journal-title":"Clin Chim Acta."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.3390\/jcm8111991","article-title":"Association between albumin-globulin ratio and mortality in patients with chronic kidney disease","volume":"8","author":"Wu","year":"2019","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12882-020-1707-1","article-title":"Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study","volume":"21","author":"Peng","year":"2020","journal-title":"BMC Nephrol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e12290","DOI":"10.1097\/MD.0000000000012290","article-title":"The impact of previous abdominal surgery on clinical characteristics and prognosis of pyogenic liver abscess: a 10-year retrospective study of 392 patients","volume":"97","author":"Zhang","year":"2018","journal-title":"Medicine."},{"key":"B23","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1186\/s12879-019-3837-2","article-title":"Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients <65 years of age versus >\/= 65 years of age","volume":"19","author":"Zhang","year":"2019","journal-title":"BMC Infect Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1089\/sur.2020.245","article-title":"Clinical features and prognosis of gas-forming and non-gas-forming pyogenic liver abscess: a comparative study","volume":"22","author":"Zhang","year":"2021","journal-title":"Surg Infect."},{"key":"B25","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/S0034-5288(18)30528-9","article-title":"Some biochemical indices in naturally occurring fascioliasis in goats","volume":"40","author":"Swarup","year":"1986","journal-title":"Res Vet Sci."},{"key":"B26","doi-asserted-by":"publisher","first-page":"439","DOI":"10.5152\/tjg.2017.17167","article-title":"Preoperative albumin\/globulin ratio is a potential prognosis predicting biomarker in patients with resectable gastric cancer","volume":"28","author":"Xue","year":"2017","journal-title":"Turk J Gastroenterol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1980","DOI":"10.21037\/tau-20-823","article-title":"Albumin-globulin ratio: a novel predictor of sepsis after flexible ureteroscopy in patients with solitary proximal ureteral stones","volume":"9","author":"Lu","year":"2020","journal-title":"Transl Androl Urol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1002\/cld.487","article-title":"Pyogenic liver abscess","volume":"6","author":"Longworth","year":"2015","journal-title":"Clin Liver Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"38587","DOI":"10.1038\/srep38587","article-title":"A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015","volume":"6","author":"Qian","year":"2016","journal-title":"Sci Rep."},{"key":"B30","doi-asserted-by":"publisher","first-page":"221","DOI":"10.5009\/gnl.2011.5.2.221","article-title":"A 10-year retrospective analysis of clinical profiles, laboratory characteristics and management of pyogenic liver abscesses in a chinese hospital","volume":"5","author":"Zhu","year":"2011","journal-title":"Gut Liver."},{"key":"B31","doi-asserted-by":"publisher","first-page":"3221","DOI":"10.1007\/s00405-019-05595-2","article-title":"Pretreatment low prognostic nutritional index and low albumin-globulin ratio are predictive for overall survival in nasopharyngeal cancer","volume":"276","author":"Gundog","year":"2019","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"3545","DOI":"10.2147\/CMAR.S191288","article-title":"The prognostic value of serum albumin-globulin ratio in early-stage non-small cell lung cancer: a retrospective study","volume":"11","author":"Wang","year":"2019","journal-title":"Cancer Manag Res."},{"key":"B33","doi-asserted-by":"publisher","first-page":"11999","DOI":"10.1038\/s41598-020-68975-3","article-title":"The prognostic role of preoperative serum albumin\/globulin ratio in patients with non-metastatic renal cell carcinoma undergoing partial or radical nephrectomy","volume":"10","author":"Chung","year":"2020","journal-title":"Sci Rep."},{"key":"B34","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s00405-020-06145-x","article-title":"Retrospective study on the potential of albumin\/globulin ratio as a prognostic biomarker for oral cavity cancer patients","volume":"278","author":"Wang","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1080\/01635581.2019.1651347","article-title":"Predicting the prognosis of gastric cancer by albumin\/globulin ratio and the prognostic nutritional index","volume":"72","author":"Zhang","year":"2020","journal-title":"Nutr Cancer."},{"key":"B36","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s00068-018-0925-8","article-title":"Neutrophil-to-lymphocyte ratio as a feasible prognostic marker for pyogenic liver abscess in the emergency department","volume":"45","author":"Park","year":"2019","journal-title":"Eur J Trauma Emerg Surg."},{"key":"B37","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1007\/BF00299085","article-title":"Pyogenic liver abscess: studies of therapy and analysis of risk factors","volume":"18","author":"Mischinger","year":"1994","journal-title":"World J Surg."},{"key":"B38","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1089\/sur.2019.278","article-title":"Outcomes of gas-forming pyogenic liver abscess are comparable to non-gas-forming pyogenic liver abscess in the era of multi-modal care: a propensity score matched study","volume":"21","author":"Chan","year":"2020","journal-title":"Surg Infect."},{"key":"B39","doi-asserted-by":"publisher","first-page":"427","DOI":"10.21203\/rs.2.24160\/v1","article-title":"Clinical features and prognosis of gas-forming and non-gas-forming pyogenic liver abscess: a comparative study","volume":"22","author":"Zhang","year":"2021","journal-title":"Surg Infect."},{"key":"B40","doi-asserted-by":"publisher","first-page":"35890","DOI":"10.1038\/srep35890","article-title":"Clinical charateristics and outcome of pyogenic liver abscess with different size: 15-year experience from a single center","volume":"6","author":"Du","year":"2016","journal-title":"Sci Rep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1086\/425616","article-title":"Pyogenic liver abscess: recent trends in etiology and mortality","volume":"39","author":"Rahimian","year":"2004","journal-title":"Clin Infect Dis."},{"key":"B42","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1016\/S1499-3872(16)60127-3","article-title":"Patients with culture negative pyogenic liver abscess have the same outcomes compared to those with Klebsiella pneumoniae pyogenic liver abscess","volume":"15","author":"Shelat","year":"2016","journal-title":"Hepatobiliary Pancreat Dis Int."},{"key":"B43","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1007\/s00508-005-0481-1","article-title":"Pyogenic liver abscesses with Escherichia coli: etiology, clinical course, outcome, prognostic factors","volume":"117","author":"Chen","year":"2005","journal-title":"Wien Klin Wochenschr."},{"key":"B44","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1089\/sur.2020.474","article-title":"Aeromonas caviae and Aeromonas veronii causing acute cholecystitis","volume":"22","author":"Teng","year":"2021","journal-title":"Surg Infect."},{"key":"B45","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jviscsurg.2015.01.013","article-title":"Hepatic abscess: diagnosis and management","volume":"152","author":"Lardiere-Deguelte","year":"2015","journal-title":"J Visc Surg."},{"key":"B46","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/S0009-9260(97)80223-1","article-title":"Pyogenic liver abscess: treatment with needle aspiration","volume":"52","author":"Ch Yu","year":"1997","journal-title":"Clin Radiol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1055\/s-2001-15845","article-title":"[Pyogenic liver abscess: interventional versus surgical therapy: technique, results and indications]","volume":"173","author":"Vogl","year":"2001","journal-title":"Rofo."},{"key":"B48","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1002\/hep.20133","article-title":"Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration","volume":"39","author":"Yu","year":"2004","journal-title":"Hepatology."},{"key":"B49","doi-asserted-by":"publisher","first-page":"2535","DOI":"10.1007\/s00268-015-3126-1","article-title":"Pyogenic liver abscess: does Escherichia coli cause more adverse outcomes than klebsiella pneumoniae?","volume":"39","author":"Shelat","year":"2015","journal-title":"World J Surg."},{"key":"B50","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.amjsurg.2015.03.002","article-title":"Percutaneous drainage for giant pyogenic liver abscess\u2013is it safe and sufficient?","volume":"211","author":"Ahmed","year":"2016","journal-title":"Am J Surg."},{"key":"B51","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/SAP.0b013e3181c47d71","article-title":"Grading of severity of the condition in burn patients by serum protein and albumin\/globulin studies","volume":"65","author":"Kumar","year":"2010","journal-title":"Ann Plast Surg."},{"key":"B52","doi-asserted-by":"publisher","first-page":"2341","DOI":"10.7150\/jca.24889","article-title":"prognostic value of albumin\/globulin ratio in survival and lymph node metastasis in patients with cancer: a systematic review and meta-analysis","volume":"9","author":"Chi","year":"2018","journal-title":"J Cancer."},{"key":"B53","doi-asserted-by":"publisher","first-page":"4923","DOI":"10.21037\/jtd.2018.07.47","article-title":"Application of albumin\/globulin ratio in elderly patients with acute exacerbation of chronic obstructive pulmonary disease","volume":"10","author":"Qin","year":"2018","journal-title":"J Thorac Dis."},{"key":"B54","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.chest.2017.10.006","article-title":"SIRS in the time of sepsis-3","volume":"153","author":"Simpson","year":"2018","journal-title":"Chest."},{"key":"B55","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ijsu.2019.10.022","article-title":"A prospective validation of sepsis-3 guidelines in acute hepatobiliary sepsis: qSOFA lacks sensitivity and SIRS criteria lacks specificity (cohort study)","volume":"72","author":"Mak","year":"2019","journal-title":"Int J Surg."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.677799\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T10:32:12Z","timestamp":1638354732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.677799\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,30]]},"references-count":55,"alternative-id":["10.3389\/fsurg.2021.677799"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2021.677799","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,30]]},"article-number":"677799"}}