Post-embolisation fever is relatively common after transarterial chemoembolisation (TACE) for hepatocellular carcinoma (HCC), and because it resembles postoperative infection, it is a problem to be managed in the early post-operative period. This retrospective cohort study took 182 patients with HCC who received TACE at Guangyuan Central Hospital between January 2018 and December 2023. Fever was defined as a body temperature of during the postoperative observation period, and infection was determined based on clinical signs, laboratory results, microbiological data and imaging findings. Fever after TACE occurred in 65 people (35.71%), and there were also 14 cases of postoperative infection (7.69%). Multivariable logistic regression indicated that a tumour diameter > 5 cm, iodized oil dose > 5 mL and the use of drug-eluting microspheres increased the odds of postoperative fever, while age 60 years was associated with a reduced adjusted odds of fever. Portal vein tumour thrombus and ascites are both independently associated with postoperative infection. Among the febrile patients, the time to the first fever and peak temperature did not differentiate between infectious and non-infectious fevers, but the duration of fever was longer in infectious fever compared to non-infectious fever. Based on the above results, post-TACE fever should be evaluated in conjunction with the extent of the tumor, severity of embolization, presence of portal vein invasion, ascites, continued fever, and so on, to avoid unnecessary antibiotics for all cases.
