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.
N1 - Publisher Copyright:
© 2013, Springer-Verlag Berlin Heidelberg.
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
UR - https://www.scopus.com/pages/publications/84919840825
UR - https://www.scopus.com/pages/publications/84919840825#tab=citedBy
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 -