Trop Med Health. 2025 Nov 6;53(1):153. doi: 10.1186/s41182-025-00832-3.
ABSTRACT
BACKGROUND: Hepatic cystic echinococcosis (HCE) remains a significant public health issue in endemic countries. Although recurrence is a recognized challenge, its independent impact on adverse clinical outcomes such as postoperative complications (POC), mortality, and length of hospital stay (LHS) remains poorly studied in Latin America. This study aimed to assess the risk of POC, mortality, and LHS in patients with recurrence of HCE.
METHODS: We conducted a retrospective cohort study of patients who underwent surgery for HCE between 1993 and 2019 at two centers in southern Chile. Patients with recurrence (exposed group) were compared to those undergoing primary surgery (non-exposed group). The primary outcome was the presence of POC; secondary outcomes included mortality and LHS. Crude and adjusted relative risks (RR) with 95% confidence intervals were estimated using Poisson regression with robust errors. Linear regression models were applied to assess the effect of recurrence on LHS.
RESULTS: A total of 154 patients with 271 cysts were included. Recurrence was identified in 43 patients (27.9%). POC occurred in 18.2% of the total cohort and were significantly more frequent in the recurrence group (41.9% vs. 9.0%, p < 0.001). Adjusted RR for POC in the presence of recurrence was 5.1 (95% CI 2.7-9.9). Mortality was higher in patients with recurrence (7.0% vs. 2.7%, RR: 2.6; 95% CI 0.5-12.3), though not statistically significant. LHS was 1 day longer in the recurrence group (7.3 ± 4.5 vs. 5.6 ± 3.4; p = 0.02), but this association lost significance in regression models.
CONCLUSIONS: Recurrence of HCE increases the risk of POC. While trends toward higher mortality and prolonged LHS were observed, these did not reach statistical significance. These findings underscore the importance of long-term follow-up and the need to identify prognostic factors for recurrence to optimize outcomes in patients with HCE in endemic regions.
PMID:41199324 | DOI:10.1186/s41182-025-00832-3
