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European Journal of Trauma and Emergency Surgery

Erschienen in:

01.10.2014 | Original Article

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

verfasst von: 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

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2014

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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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Titel: Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management
verfasst von: 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
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 5/2014
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-013-0346-7

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