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

Autor:	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.
Předmět:	LIVER injuries ABSCESSES ASPARTATE aminotransferase BLUNT trauma FISHER exact test HYDROGEN-ion concentration MULTIVARIATE analysis STATISTICS TRAUMA centers LOGISTIC regression analysis ALANINE aminotransferase RECEIVER operating characteristic curves DATA analysis software DESCRIPTIVE statistics MANN Whitney U Test DISEASE complications THERAPEUTICS DISEASE risk factors
Zdroj:	European Journal of Trauma & Emergency Surgery; Oct2014, Vol. 40 Issue 5, p547-552, 6p, 3 Charts, 1 Graph
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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