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Risk factors for complications after partial splenic embolization for liver cirrhosis.
British Journal of Surgery 2008 June
BACKGROUND: Partial splenic embolization (PSE) in patients with cirrhosis can achieve a prolonged increase in blood cell count. However, there is little information on the risk factors for complications after PSE for liver cirrhosis.
METHODS: Seventy patients (41 men and 29 women) with cirrhosis-induced hypersplenism underwent PSE. Based on the Child-Pugh classification, 30, 35 and five patients had class A, B and C disease respectively. Risk factors for complications after PSE were examined retrospectively by logistic regression analysis.
RESULTS: The mean splenic infarction rate was 77.1 per cent. Twelve patients (17 per cent) had complications following PSE. In univariable analysis, Child-Pugh class C, total bilirubin level of 1.4 mg/dl or more, serum albumin level of 2.8 g/dl or less and infarcted splenic volume of 540 ml or more were significantly associated with complications after PSE. In multivariable analysis, Child-Pugh class C (P = 0.012) and infarcted splenic volume of 540 ml or more (P = 0.031) were identified as risk factors, with an odds ratio of 22.92 and 5.01 respectively.
CONCLUSION: Child-Pugh class C and a large splenic infarction volume are risk factors for complications after PSE for liver cirrhosis.
METHODS: Seventy patients (41 men and 29 women) with cirrhosis-induced hypersplenism underwent PSE. Based on the Child-Pugh classification, 30, 35 and five patients had class A, B and C disease respectively. Risk factors for complications after PSE were examined retrospectively by logistic regression analysis.
RESULTS: The mean splenic infarction rate was 77.1 per cent. Twelve patients (17 per cent) had complications following PSE. In univariable analysis, Child-Pugh class C, total bilirubin level of 1.4 mg/dl or more, serum albumin level of 2.8 g/dl or less and infarcted splenic volume of 540 ml or more were significantly associated with complications after PSE. In multivariable analysis, Child-Pugh class C (P = 0.012) and infarcted splenic volume of 540 ml or more (P = 0.031) were identified as risk factors, with an odds ratio of 22.92 and 5.01 respectively.
CONCLUSION: Child-Pugh class C and a large splenic infarction volume are risk factors for complications after PSE for liver cirrhosis.
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