Radiofrequency ablation (RFA) increasingly is used to treat patients with primary or metastatic liver tumors who cannot tolerate a formal hepatic resection. Subsequently, procedure-related and post-operative morbidity has increased, although mortality has remained low.
These researchers used data from the 2006–2009 National Impatient Sample to describe in-hospital morbidity associated with RFA and to identify predictors of adverse events. Most patients were male (62%), under age 65, treated for metastatic liver lesions (57.5%) in centers performing at least 16 cases a year. Overall, procedure-specific complications were experienced by 18 percent of patients; post-operative complications by 12 percent.
The likelihood of procedure-specific complications (e.g.,requiring a transfusion, having intraoperative bleeding, or experiencing hepatic failure) was higher with the open surgical approach, compared to percutaneous or laparoscopic approaches. Patients treated in hospitals with annual RFA volume greater than 16 cases a year had a 41 percent reduction in the odds of procedure-specific complications.
Several patient factors—cardiac arrhythmias, heart failure, and coagulopathy—were associated with more frequent post-operative complications. The percutaneous procedural approach, however, was associated with a lower likelihood of post-operative complications.