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Risk factors and a predictive model for acute hepatic failure after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.
MedLine Citation:
PMID:  23295052     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Acute hepatic failure (AHF) is one of the most serious complications of transcatheter arterial chemoembolization (TACE). The aims of this study were to investigate risk factors of AHF after TACE and to establish a predictive model for AHF.
METHODS: In the evaluation set, a total of 820 patients who underwent TACE as a first treatment for hepatocellular carcinoma were included. The demographic, laboratory, radiological and treatment-related factors were analysed to identify risk factors for AHF after TACE and a predictive model was established using the identified risk factors. In the validation set, a different cohort of 438 patients was included to validate the predictive model.
RESULTS: The incidence of post-TACE AHF was 15.1% (124/820). Multivariate analysis revealed that presence of portal vein thrombosis, high aspartate aminotransferase, bilirubin, and log alpha-foetoprotein levels, and low albumin and sodium levels were independent risk factors. A mathematical model was established using these independent risk factors, and the area under the receiver operating characteristic curve of the model was 0.773 (95% confidence interval, 0.726-0.820). The cut-off value of 9 had a sensitivity of 78.2%, a specificity of 72.3%, a positive likelihood ratio of 2.82, a negative likelihood ratio of 0.30, a positive predictive value of 28.9% and a negative predictive value of 95.8%.
CONCLUSIONS: The risk factors of post-TACE AHF were presence of portal vein thrombosis, high aspartate aminotransferase, bilirubin, and alpha-foetoprotein levels, and low serum albumin and sodium levels. A mathematical model to predict post-TACE AHF was established.
Authors:
Yang Won Min; Jeong Kim; Seonwoo Kim; Young Kyung Sung; Jin Hee Lee; Geum-Youn Gwak; Yong Han Paik; Moon Seok Choi; Kwang Cheol Koh; Seung Woon Paik; Byung Chul Yoo; Joon Hyeok Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  33     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-202     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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