• C-P Hsu, S-Y Wang, Y-P Hsu, H-W Chen, B-C Lin, S-C Kang, K-C Yuan, E-H Liu, I-M Kuo, C-H Liao, C-H Ouyang, and S-J Yang.
• Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei Shan Township, Taoyuan, Taiwan.
• Eur J Trauma Emerg Surg. 2014 Oct 1; 40 (5): 547-52.

PurposeTo identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM).MethodsFrom January 2004 to October 2008, retrospective data were collected from a single level I trauma center. Clinical data, hospital course, and outcome were all extracted from patient medical records for further analysis.ResultsA total of 358 patients were enrolled for analysis. There were 13 patients with liver abscess after blunt hepatic injury. Patients with abscess had a significant increase in glutamic oxaloacetic transaminase (GOT, p = 0.006) and glutamic pyruvic transaminase (GPT, p < 0.0001), and a decrease in arterial blood pH (p = 0.023) compared to patients without abscess in the univariate analyses. In addition, high-grade hepatic injury and transarterial embolization (TAE, p < 0.001) were also risk factors for liver abscess formation. Five factors (GOT, GPT, pH level in the arterial blood sample, TAE, and high-grade hepatic injury) were included in the multivariate analysis. TAE, high-grade hepatic injury, and GPT level were statistically significant. The odds ratios of TAE and high-grade hepatic injury were 15.41 and 16.08, respectively. A receiver operating characteristic (ROC) analysis was used for GPT, and it suggested cutoff values of 372.5 U/L. A prediction model based on the ROC analysis had 100 % sensitivity and 86.7 % specificity to predict liver abscess formation in patients with two of the three independent risk factors.ConclusionsTAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.

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