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

Research output: Contribution to journalArticle

2 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 languageEnglish
Pages (from-to)547-552
Number of pages6
JournalEuropean Journal of Trauma and Emergency Surgery
Volume40
Issue number5
DOIs
Publication statusPublished - Oct 16 2014
Externally publishedYes

Fingerprint

Liver Abscess
Nonpenetrating Wounds
Liver
Wounds and Injuries
ROC Curve
Abscess
Trauma Centers
Aspartate Aminotransferases
Alanine Transaminase
Medical Records
Multivariate Analysis
Odds Ratio
Sensitivity and Specificity

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

Cite this

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

In: European Journal of Trauma and Emergency Surgery, Vol. 40, No. 5, 16.10.2014, p. 547-552.

Research output: Contribution to journalArticle

Hsu, CP, Wang, SY, Hsu, YP, Chen, HW, Lin, BC, Kang, SC, Yuan, KC, Liu, EH, Kuo, IM, Liao, CH, Ouyang, CH & Yang, SJ 2014, 'Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management', European Journal of Trauma and Emergency Surgery, vol. 40, no. 5, pp. 547-552. https://doi.org/10.1007/s00068-013-0346-7
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. / Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management. In: European Journal of Trauma and Emergency Surgery. 2014 ; Vol. 40, No. 5. pp. 547-552.
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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.",
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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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