Risk factors for infectious complications in primary liver cancer

Objective To investigate the risk factors for infectious complications in patients with primary liver cancer. Methods A retrospective analysis was performed for the clinical data of 3034 patients with primary liver cancer who were admitted to 302 Hospital of PLA from February 2016 to February 2017, and among these patients, 297 experienced infectious complications and 2737 did not experience infectious complications; 153 patients with infectious complications were enrolled as infection group, and 46 without infectious complications were enrolled as non-infection group. There were 133 male and 20 female patients aged 34-75 years ( mean 56. 41 ± 6. 69 years) in the infection group, and 37 male and 9 female patients aged 47-74 years ( mean 57. 52 ± 11. 12 years) in the non-infection group. The association between possible risk factors and infectious complications in patients with primary liver cancer was analyzed. The t test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank sum test was used for comparison of continuous data with skewed distribution between two groups. The chi-square test was used for univariate analysis, and the multivariate logistic regression analysis was used for multivariate analysis. Results The multivariate logistic regression analysis showed that age ≤60 years ( OR = 5. 048, P <0. 001) , long course of hepatitis B and liver cancer ( OR = 2. 446, P = 0. 035, OR = 0. 433, P = 0. 016) , high HBV DNA ( OR = 2. 618, P =0. 005) , high white blood cell count ( OR = 1. 170, P = 0. 001) , high levels of alpha-fetoprotein ( AFP) ( OR = 0. 470, P = 0. 032) , alkaline phosphatase ( OR = 1. 004, P = 0. 004) , and gamma-glutamyl transpeptidase ( OR = 1. 004, P = 0. 006) , high Child-Pugh score ( OR = 0. 167, P = 0. 004) , low albumin ( OR = 0. 999, P < 0. 001) and cholinesterase ( OR = 0. 834, P < 0. 001) , long prothrombin time ( OR = 1. 299, P = 0. 007) , large maximum tumor diameter ( OR = 0. 389, P < 0. 005) , and presence of portal vein tumor thrombus ( OR =2. 378, P = 0. 018) were independent risk factors for infection in patients with primary liver cancer and HBV infection ( all P < 0. 05) . Conclusion Infection in patients with primary liver cancer is associated with risk factors including age of onset, course of hepatitis B and liver cancer, tumor diameter, portal vein tumor thrombus, HBV DNA and AFP levels, and liver function, which should be taken seriously in clinical practice. Active measures should be adopted to reduce infectious complications.