Risk factors analysis of perioperative mortality in ruptured bleeding of hepatocellular carcinoma
LIN Gao-Ming, SHU Jia, LI Guo-Lin, MIN Jun
Chinese Journal of Clinical Anatomy ›› 2014, Vol. 32 ›› Issue (5) : 616-619.
Risk factors analysis of perioperative mortality in ruptured bleeding of hepatocellular carcinoma
Objective Rupture of hepatocellular carcinoma (HCC) is a catastrophic emergency with high mortality. The aim of this study is to determine the factors associated with the prognosis and to assess the outcome of different management strategies. Methods Clinical and biochemical factors of 60 consecutive patients with rupture of HCC from 2005 to 2013 were studied. Univariate logistic regression analysis was performed to determine the relative factors leading to 30-day motality. Significant factors then entered into a multivariate logistic regression to determine independent factors associated with 30-day motality. Results In our study, 30-day mortality rate was 28.3% (n=17). Child’s C status, shock on admission, higher blood transfusion requirement and larger tumor size were with statistical significance on univariate analysis. On multivariate analysis, only shock on admission (P=0.001) and higher blood transfusion requirement (P=0.01) were significant independent factors affecting early post-operative mortality. A larger tumor size was identified as an independent factor related to post- TAE mortality. Curative resection was associated with a better 30-day survival as compared with conservative therapy or palliative operation. Conclusions Rupture of HCC is a salvageable complication of HCC. Poor prognosis is associated with poor liver reserve, advanced disease and severity of haemorrhage. Curative resection and TAE are better choices in selected patients.
Hepatocellular carcinoma (HCC) / Spontaneous rupture / Hepatectomy
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