Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management

C. P. Hsu; S. Y. Wang; Y. P. Hsu; H. W. Chen; B. C. Lin; S. C. Kang; K. C. Yuan; E. H. Liu; I. M. Kuo; C. H. Liao; C. H. Ouyang; S. J. Yang

doi:10.1007/s00068-013-0346-7

Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management

C. P. Hsu, S. Y. Wang, Y. P. Hsu, H. W. Chen, B. C. Lin, S. C. Kang, K. C. Yuan, E. H. Liu, I. M. Kuo, C. H. Liao, C. H. Ouyang, S. J. Yang

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4 Citations (Scopus)

Abstract

Purpose: To identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM).

Methods: From January 2004 to October 2008, retrospective data were collected from a single level I trauma center. Clinical data, hospital course, and outcome were all extracted from patient medical records for further analysis.

Results: A total of 358 patients were enrolled for analysis. There were 13 patients with liver abscess after blunt hepatic injury. Patients with abscess had a significant increase in glutamic oxaloacetic transaminase (GOT, p = 0.006) and glutamic pyruvic transaminase (GPT, p < 0.0001), and a decrease in arterial blood pH (p = 0.023) compared to patients without abscess in the univariate analyses. In addition, high-grade hepatic injury and transarterial embolization (TAE, p < 0.001) were also risk factors for liver abscess formation. Five factors (GOT, GPT, pH level in the arterial blood sample, TAE, and high-grade hepatic injury) were included in the multivariate analysis. TAE, high-grade hepatic injury, and GPT level were statistically significant. The odds ratios of TAE and high-grade hepatic injury were 15.41 and 16.08, respectively. A receiver operating characteristic (ROC) analysis was used for GPT, and it suggested cutoff values of 372.5 U/L. A prediction model based on the ROC analysis had 100 % sensitivity and 86.7 % specificity to predict liver abscess formation in patients with two of the three independent risk factors.

Conclusions: TAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.

Original language	English
Pages (from-to)	547-552
Number of pages	6
Journal	European Journal of Trauma and Emergency Surgery
Volume	40
Issue number	5
DOIs	https://doi.org/10.1007/s00068-013-0346-7
Publication status	Published - Oct 16 2014
Externally published	Yes

Keywords

Hepatic injury
Liver abscess
Liver injury
Liver laceration
Non-operative management
Transarterial embolization

ASJC Scopus subject areas

Surgery
Emergency Medicine
Orthopedics and Sports Medicine
Critical Care and Intensive Care Medicine

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10.1007/s00068-013-0346-7

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Hsu, C. P., Wang, S. Y., Hsu, Y. P., Chen, H. W., Lin, B. C., Kang, S. C., Yuan, K. C., Liu, E. H., Kuo, I. M., Liao, C. H., Ouyang, C. H., & Yang, S. J. (2014). Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management. European Journal of Trauma and Emergency Surgery, 40(5), 547-552. https://doi.org/10.1007/s00068-013-0346-7

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title = "Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management",

abstract = "Purpose: To identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM).Methods: From January 2004 to October 2008, retrospective data were collected from a single level I trauma center. Clinical data, hospital course, and outcome were all extracted from patient medical records for further analysis.Results: A total of 358 patients were enrolled for analysis. There were 13 patients with liver abscess after blunt hepatic injury. Patients with abscess had a significant increase in glutamic oxaloacetic transaminase (GOT, p = 0.006) and glutamic pyruvic transaminase (GPT, p < 0.0001), and a decrease in arterial blood pH (p = 0.023) compared to patients without abscess in the univariate analyses. In addition, high-grade hepatic injury and transarterial embolization (TAE, p < 0.001) were also risk factors for liver abscess formation. Five factors (GOT, GPT, pH level in the arterial blood sample, TAE, and high-grade hepatic injury) were included in the multivariate analysis. TAE, high-grade hepatic injury, and GPT level were statistically significant. The odds ratios of TAE and high-grade hepatic injury were 15.41 and 16.08, respectively. A receiver operating characteristic (ROC) analysis was used for GPT, and it suggested cutoff values of 372.5 U/L. A prediction model based on the ROC analysis had 100 % sensitivity and 86.7 % specificity to predict liver abscess formation in patients with two of the three independent risk factors.Conclusions: TAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.",

keywords = "Hepatic injury, Liver abscess, Liver injury, Liver laceration, Non-operative management, Transarterial embolization",

author = "Hsu, {C. P.} and Wang, {S. Y.} and Hsu, {Y. P.} and Chen, {H. W.} and Lin, {B. C.} and Kang, {S. C.} and Yuan, {K. C.} and Liu, {E. H.} and Kuo, {I. M.} and Liao, {C. H.} and Ouyang, {C. H.} and Yang, {S. J.}",

note = "Publisher Copyright: {\textcopyright} 2013, Springer-Verlag Berlin Heidelberg.",

year = "2014",

month = oct,

day = "16",

doi = "10.1007/s00068-013-0346-7",

language = "English",

volume = "40",

pages = "547--552",

journal = "European Journal of Trauma and Emergency Surgery",

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TY - JOUR

T1 - Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management

AU - Hsu, C. P.

AU - Wang, S. Y.

AU - Hsu, Y. P.

AU - Chen, H. W.

AU - Lin, B. C.

AU - Kang, S. C.

AU - Yuan, K. C.

AU - Liu, E. H.

AU - Kuo, I. M.

AU - Liao, C. H.

AU - Ouyang, C. H.

AU - Yang, S. J.

PY - 2014/10/16

Y1 - 2014/10/16

N2 - Purpose: To identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM).Methods: From January 2004 to October 2008, retrospective data were collected from a single level I trauma center. Clinical data, hospital course, and outcome were all extracted from patient medical records for further analysis.Results: A total of 358 patients were enrolled for analysis. There were 13 patients with liver abscess after blunt hepatic injury. Patients with abscess had a significant increase in glutamic oxaloacetic transaminase (GOT, p = 0.006) and glutamic pyruvic transaminase (GPT, p < 0.0001), and a decrease in arterial blood pH (p = 0.023) compared to patients without abscess in the univariate analyses. In addition, high-grade hepatic injury and transarterial embolization (TAE, p < 0.001) were also risk factors for liver abscess formation. Five factors (GOT, GPT, pH level in the arterial blood sample, TAE, and high-grade hepatic injury) were included in the multivariate analysis. TAE, high-grade hepatic injury, and GPT level were statistically significant. The odds ratios of TAE and high-grade hepatic injury were 15.41 and 16.08, respectively. A receiver operating characteristic (ROC) analysis was used for GPT, and it suggested cutoff values of 372.5 U/L. A prediction model based on the ROC analysis had 100 % sensitivity and 86.7 % specificity to predict liver abscess formation in patients with two of the three independent risk factors.Conclusions: TAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.

AB - Purpose: To identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM).Methods: From January 2004 to October 2008, retrospective data were collected from a single level I trauma center. Clinical data, hospital course, and outcome were all extracted from patient medical records for further analysis.Results: A total of 358 patients were enrolled for analysis. There were 13 patients with liver abscess after blunt hepatic injury. Patients with abscess had a significant increase in glutamic oxaloacetic transaminase (GOT, p = 0.006) and glutamic pyruvic transaminase (GPT, p < 0.0001), and a decrease in arterial blood pH (p = 0.023) compared to patients without abscess in the univariate analyses. In addition, high-grade hepatic injury and transarterial embolization (TAE, p < 0.001) were also risk factors for liver abscess formation. Five factors (GOT, GPT, pH level in the arterial blood sample, TAE, and high-grade hepatic injury) were included in the multivariate analysis. TAE, high-grade hepatic injury, and GPT level were statistically significant. The odds ratios of TAE and high-grade hepatic injury were 15.41 and 16.08, respectively. A receiver operating characteristic (ROC) analysis was used for GPT, and it suggested cutoff values of 372.5 U/L. A prediction model based on the ROC analysis had 100 % sensitivity and 86.7 % specificity to predict liver abscess formation in patients with two of the three independent risk factors.Conclusions: TAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.

KW - Hepatic injury

KW - Liver abscess

KW - Liver injury

KW - Liver laceration

KW - Non-operative management

KW - Transarterial embolization

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U2 - 10.1007/s00068-013-0346-7

DO - 10.1007/s00068-013-0346-7

M3 - Article

AN - SCOPUS:84919840825

SN - 1863-9933

VL - 40

SP - 547

EP - 552

JO - European Journal of Trauma and Emergency Surgery

JF - European Journal of Trauma and Emergency Surgery

IS - 5

ER -

Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management

Abstract

Keywords

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