title: Risk factor analysis of perioperative mortality after ruptured bleeding in hepatocellular carcinoma.
abstract: OBJECTIVE
  To discuss strategies and prognosis for the emergency treatment of ruptured bleeding in primary hepatocellular carcinoma.
  
  
  METHODS
  The retrospective analysis was performed by examining the emergency treatment experiences of 60 cases of ruptured bleeding in primary hepatocellular carcinoma. The treatment methods included surgical tumour resection, transcatheter arterial embolization (TAE) and non-surgical treatment. Univariate and multivariate analyses were performed to identify the risk factors that impacted 30-d mortality in the research groups.
  
  
  RESULTS
  The 30-d mortality of all patients was 28.3% (n = 17). The univariate analysis showed that Child-Pugh C level liver function, shock, massive blood transfusion and large tumour volume were risk factors that influenced 30-d mortality. The multivariate analysis showed that shock and massive blood transfusion were independent risk factors that impacted the 30-d mortality of surgical resection. As for the TAE patients, larger tumour volume was a risk factor towards prognosis.
  
  
  CONCLUSIONS
  Radical resection and TAE therapy would achieve better results in carefully selected ruptured hepatocellular tumours.
authors.affiliation: Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Hao-Ming
authors.initials: HM
authors.lastname: Lin
authors.affiliation: Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Lei
authors.affiliation: Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Guo-Lin
authors.initials: GL
authors.lastname: Li
authors.affiliation: Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Min
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000401:mortality; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D004621:Embolization, Therapeutic / Q000401:mortality; D004630:Emergencies; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012422:Rupture, Spontaneous; D012769:Shock / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Hepatocellular carcinoma; Liver resection; Spontaneous rupture