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DC Field | Value | Language |
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dc.contributor.author | Siriwardana, R.C. | |
dc.contributor.author | Niriella, M.A. | |
dc.contributor.author | Dassanayake, A.S. | |
dc.contributor.author | Liyanage, C.A.H. | |
dc.contributor.author | Upasena, A. | |
dc.contributor.author | Sirigampala, C. | |
dc.contributor.author | de Silva, H.J. | |
dc.date.accessioned | 2015-08-25T10:03:00Z | |
dc.date.available | 2015-08-25T10:03:00Z | |
dc.date.issued | 2015 | |
dc.identifier.citation | BMC Gastroenterology.2015;15:96 | en_US |
dc.identifier.issn | 1471-230X (Electronic) | |
dc.identifier.uri | http://repository.kln.ac.lk/handle/123456789/9291 | |
dc.description.abstract | BACKGROUND: Transarterial-chemo-embolization (TACE) is used for palliation of unresectable hepatocellular carcinoma (HCC). We studied the tolerability of TACE in a cohort of patients with NASH and alcoholic cirrhosis related HCC. METHODS: Of 290 patients with HCC (July 2011 - December 2014), 84 underwent TACE. They were monitored for post-TACE complications: postembolization fever (PEF), nausea and vomiting (NV), abdominal pain, infection, acute hepatic decompensation (AHD) and acute kidney injury (AKI). RESULTS: 84 patients [90.5 % males, 89.2 % cirrhotics, 89.2 % nodular HCC, median age 63 (34-84) years] underwent 111 TACE sessions. All were Child class A [69.4 % sessions (n = 77)] or B; ascites and portal vein invasion was present in 18 (16.2 %) and 15 (13.6 %), respectively. 42 (38.2 %) TACE procedures resulted in complications [PEF 28 (25.2 %), NV 4 (3.6 %), abdominal pain 9 (8.1 %), infection 7 (6.3 %), AHD 13 (11.7 %), AKI 3 (2.7 %)]. There were no immediate post-TACE deaths. On univariate analysis elevated serum bilirubin (p = 0.046) and low serum albumin (p = 0.035) predicted PEF while low serum albumin (p = 0.021) and low platelet counts (p = 0.041) predicted AHD. In the multivariate model, factors with p < 0.200 on univariate analysis and factors derived from the previous literature were considered covariates. Female gender (p = 0.029, OR = 1.412), ascites (p = 0.030, OR = 1.212), elevated serum bilirubin (p = 0.007, OR = 4.357) and large tumour size (p = 0.036, OR = 3.603) were independent risk factors for PEF. Tumour diameter >5 cm (p = 0.049, OR = 2.410) and elevated serum bilirubin (p = 0.036, OR = 1.517) predicted AHD. CONCLUSION: In NASH and alcoholic cirrhosis related HCC patients pre-procedure serum bilirubin, ascites, tumour size and female gender predicted PEF post-TACE. Tumours larger 5 cm with elevated bilirubin predicted AHD post-TACE. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | BioMed Central | en_US |
dc.subject | Post-embolization fever | en_US |
dc.title | Factors affecting post-embolization fever and liver failure after trans-arterial chemo-embolization in a cohort without background infective hepatitis- a prospective analysis | en_US |
dc.type | Article | en_US |
Appears in Collections: | Journal/Magazine Articles |
Files in This Item:
File | Description | Size | Format | |
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siriwardhana.BMCgastro.2015.pdf | 340.76 kB | Adobe PDF | View/Open |
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