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

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

4 Scopus citations

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.

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

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.

Original languageEnglish
Pages (from-to)547-552
Number of pages6
JournalEuropean Journal of Trauma and Emergency Surgery
Volume40
Issue number5
DOIs
StatePublished - 16 10 2014

Bibliographical note

Publisher Copyright:
© 2013, Springer-Verlag Berlin Heidelberg.

Keywords

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

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