全国性的肝脓肿发病率正在增加。目前估计的全国发病率范围从每10万住院患者中的8到20个肝脓肿。了解危险因素对于高效诊断和治疗肝脓肿至关重要。本研究旨在评估中西部地区一个农村地区与大都市地区相比，肝脓肿发病率是否更高。同时还考虑了水基础设施因素。我们对2016年1月1日至2019年12月31日之间，位于南达科他州的一家中部地区医院系统的所有以肝脓肿诊断入院的患者进行了回顾性病历审查。收集了微生物学培养和患者的人口统计数据，包括年龄、性别、故乡和种族。评估的危险因素包括腹部手术史、胆囊疾病、败血症、结肠憩室炎、癌症和糖尿病。使用泊松率检验和置信区间方程计算了肝脓肿的发病率。计算了每个危险因素的平均值。最后，使用故乡数据制作了疾病负担热图，并将其与该地区私人水井的密度进行了比较。 该医院在2016年至2019年期间共有116例成人肝脓肿确诊入院。纠正后的发病率为每年每10万住院患者95.66个肝脓肿。农村地区的人均发病率和私人水井的密度较高。 在这个单中心研究中，肝脓肿患者的发病率明显高于全国平均水平。人口统计特征，尤其是地理位置，可能在发病率中起重要作用。农村地理位置可能会影响肝脓肿的发病率，并可能是本研究中较高于预期发病率的一个解释。水基础设施（定义为该地区私人水井的发病率）可能是一个影响因素，因为大部分农村地区依赖未经处理的地下水。本研究的局限性在于对患有肝脓肿的患者真实用水来源的数据可用性。本研究的另一个局限性是缺乏多中心参与。 版权©南达科他州医学协会。

Incidences of hepatic abscesses are increasing nationally. Current estimates of national incidence range from 8 to 20 abscesses per 100,000 hospital admissions. Understanding risk factors is essential for efficient diagnosis and treatment of hepatic abscess. This study aimed to assess if hepatic abscess incidence in a Midwest cohort was higher in rural areas compared to metropolitan areas. Water infrastructure factors were also considered.A retrospective chart review was completed for all patients admitted with a diagnosis of hepatic abscess to an upper Midwest hospital system in South Dakota between Jan. 1, 2016 and Dec. 31, 2019. Microbiology cultures and patient demographic data were collected including age, gender, hometown, and ethnicity. Risk factors assessed included a history of abdominal surgery, gallbladder disease, sepsis, diverticulitis, cancer, and diabetes. The incidence of hepatic abscesses was calculated using the Poisson rate test and confidence interval equation. Averages of each risk factor were calculated. Finally, the hometowns were utilized to create a heat map of disease burden, which was then compared to the density of private wells in those areas.There were 116 confirmed cases of adult hepatic abscess admitted to the hospital between 2016 and 2019. The corrected incidence was 95.66 abscesses per 100,000 hospitalized patients per year. Rural areas had a higher per capita incidence of abscesses and higher density of private wells.The incidence of patients with hepatic abscesses was significantly higher than the national average in this single-center study. Demographics, especially geographic location, may play an important role in abscess rates. Rural location may be affecting the incidence of hepatic abscesses, and might be one explanation of the much higher than expected incidence found in this study. Water infrastructure, as defined as incidence of private wells in the area, could be a contributing factor as much of the rural area is reliant on untreated groundwater from wells. The study was limited by data availability on true water source usage for patients with hepatic abscesses. Another limitation to this study is the lack of multicenter involvement.Copyright© South Dakota State Medical Association.