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

SIMPLE SUMMARY: Post-radiofrequency ablation (Post-RFA) fever is a common minor complication of radiofrequency ablation in patients with hepatocellular carcinoma. We aim to evaluate the risk factors and positive blood culture rate of patients with post-RFA fever. We demonstrated that when younger people with a low serum albumin level underwent general anesthesia, the tumor numbers and tumor sizes were associated with a higher rate of post-RFA fever. A low incidence of bacteremia (4.8%) among patients with post-RFA fever was a novel finding which might indicate that prophylactic antibiotics are unnecessary for patients with hepatocellular carcinoma before ablation. 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).