Risk factors for mortality in patients with multifocal and diffuse hepatic hemangiomas
| Autor: | David Zurakowski, Harry P.W. Kozakewich, Rudy Murillo, Kristy L. Rialon, Ahmad I. Alomari, Emily R. Christison-Lagay, Steven J. Fishman, Ann M. Kulungowski, Rebecca D. Fevurly |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Abdominal compartment syndrome Kaplan-Meier Estimate Risk Assessment Gastroenterology Asymptomatic Vascular anomaly Hemangioma Risk Factors Internal medicine medicine Humans Registries Survival rate Aged Neoplasm Staging Proportional hazards model business.industry Liver Neoplasms Hazard ratio Infant Newborn Infant General Medicine Middle Aged medicine.disease Surgery Survival Rate Massachusetts Heart failure Pediatrics Perinatology and Child Health Female medicine.symptom business |
| Zdroj: | Journal of Pediatric Surgery. 50:837-841 |
| ISSN: | 0022-3468 |
| Popis: | Purpose Multifocal and diffuse hepatic hemangiomas are true infantile hemangiomas, which likely exist in a continuum. We reviewed our hepatic hemangioma registry to identify prognostic indicators for mortality. Methods Registry records entered between 1995 and 2012 were reviewed. Clinical characteristics were evaluated for prognostic significance using the multivariable Cox proportional hazards model. Survival data were analyzed using the Kaplan–Meier product–limit method. Results We identified 123 patients with multifocal (n=91) and diffuse (n=32) hepatic hemangiomas. Mortality was 16% (n=20); 40% (n=8) had multifocal and 60% (n=12) had diffuse lesions. A diagnosis of diffuse disease (hazard ratio: 9.9, 95% CI: 2.0–50.8, P =.002) and congestive heart failure (CHF) (hazard ratio: 3.9, 95% CI: 1.3–14.2, P =.031) were significant risk factors for mortality across the continuum; age at presentation, cardiomegaly, presence of shunts, and hypothyroidism were not statistically significant independent risk factors. Among patients with diffuse lesions, eight (67%) who died had abdominal compartment syndrome, which was also associated with mortality ( P =.002). Conclusions Hepatic hemangioma patients with CHF or diffuse disease are at higher risk for mortality. Patients with multifocal lesions without CHF may go undetected until lesions become diffuse. Aggressive treatment of symptomatic patients and close follow-up of asymptomatic patients may improve mortality. |
| Databáze: | OpenAIRE |
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