The Incidence of Bacteremia and Risk Factors of Post-Radiofrequency Ablation Fever for Patients with Hepato-Cellular Carcinoma

Abstract

Post-radiofrequency ablation (RFA) fever is a self-limited complication of RFA. The correlation between post-RFA fever and bacteremia and the risk factors associated with post-RFA fever have not been evaluated. Patients with newly diagnosed or recurrent hepatocellular carcinoma who underwent ultrasonography-guided RFA between April 2014 and February 2019 were retrospectively enrolled. Post-RFA fever was defined as any episode of body temperature >38.0 °C after RFA during hospitalization. A total of 272 patients were enrolled, and there were 452 applications of RFA. The frequency of post-RFA fever was 18.4% (83/452), and 65.1% (54/83) of post-RFA fevers occurred on the first day after ablation. Patients with post-RFA fever had a longer hospital stay than those without (9.06 days vs. 5.50 days, p < 0.001). Only four (4.8%) patients with post-RFA fever had bacteremia. The independent factors associated with post-RFA fever were younger age (adjusted odds ratio (OR) = 0.96, 95% CI, 0.94–0.99, p = 0.019), low serum albumin level (adjusted OR = 0.49, 95% CI, 0.25–0.95, p = 0.036), general anesthesia (adjusted OR = 2.06, 95% CI, 1.15–3.69, p = 0.015), tumor size (adjusted OR = 1.52, 95% CI, 1.04–2.02, p = 0.032), and tumor number (adjusted OR = 1.71, 95% CI, 1.20–2.45, p = 0.003).

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

“…Regarding development of fever after the procedure in the current study, there were 64 patients (64%) of the studied group who had fever; this disagrees with Chen et al, who recently reported that the frequency of post-RFA fever was 18.4% [12], while Siriwardana et al reported a 25.2% rate of fever after TACE [13]. The differences are mainly related to assessment after a single intervention by Chen et al and Siriwardana et al in comparison to many percutaneous ablation therapies in our study or may be due to different antiseptic measures followed peri-procedurally, although they were followed during our interventions.…”

“…Regarding development of fever after the procedure in the current study, there were 64 patients (64%) of the studied group who had fever; this disagrees with Chen et al ., who recently reported that the frequency of post-RFA fever was 18.4% [ 12 ], while Siriwardana et al . reported a 25.2% rate of fever after TACE [ 13 ].…”

“…Chen et al . [ 12 ] reported a rate of 4.8% positive blood cultures after RFA, while Zhang et al . [ 10 ] reported a positive culture rate of 34.7% (including blood and other body fluids) after RFA and microwave ablation.…”

Postoperative SIRS after thermal ablation of HCC: Risk factors and short-term prognosis

“…With the advantages of less trauma, faster recovery and lower hospitalization cost than conventional hepatectomy, thermal ablation has been a promising strategy for HCC. In our study of 1491 ablation sessions performed over six years, 15.7 % patients developed postoperative SIRS after thermal ablation of HCC, which is similar to the previous studies [ 10 , 19 ]. Previously our team demonstrated that thermal ablation is safe in terms of major complications related to this procedure [ 10 ].…”

Liver Cancer: Improving Standard Diagnosis and Therapy

“…Chen et al reported the clinical features of post-RFA fever. They found the independent factors associated with fever were younger age, low albumin, general anesthesia, tumor size, and tumor number [ 5 ]. Huh et al performed a metanalysis to investigate the accuracy of radiological features in diagnosing tumor viability [ 6 ].…”