Shin et al reported a model predictive of liver abscess following transarterial chemoembolization of a hepatocellular carcinoma (HCC). The authors are from Changwon Fatima Hospital and Sungkyunkwan University in South Korea.
Patient selection: hepatocellular carcinoma
Parameters:
(1) pneumobilia
(2) type 2 biliary abnormality (= prone to ascending biliary infection: bilioenteric anastomosis, endoscopic papillotomy, percutaneous transhepatic biliary drainage, T-tube choledochostomy)
(3) type 1 biliary abnormality (biliary invasion by HCC, biliary stricture, extrinsic compression of the bile duct, common bile duct stone without complications)
(4) diabetes
(5) number of tumors
(6) tumor necrosis
(7) maximum tumor diameter in cm
(8) vessel (arterial) injury during embolization
(9) gelfoam embolization
Parameters |
Finding |
Points |
pneumobilia |
no |
0 |
|
yes |
0.95327 |
type 2 biliary abnormality |
no |
0 |
|
yes |
0.86510 |
type 1 biliary abnormality |
no |
0 |
|
yes |
0.76789 |
diabetes |
no |
0 |
|
yes |
0.63245 |
number of tumors |
1 or 2 |
0 |
|
>= 3 |
0.60852 |
tumor necrosis |
no |
0 |
|
yes |
0.45788 |
tumor diameter |
< 3 cm |
0 |
|
>= 3 cm |
0.23804 |
vessel injury |
no |
0 |
|
yes |
0.87273 |
gelfoam embolization |
no |
0 |
|
yes |
0.60530 |
X =
= SUM(points for all 9 parameters)
probability of liver abscess =
= 1 / (1 + EXP((-1) * X))
Specialty: Infectious Diseases, Hematology Oncology