Outcomes of patients with post-hepatectomy hypophosphatemia: A narrative review

Table 2 Summary of laboratory values and post-operative outcomes comparing patients with post-hepatectomy hypophosphatemia and normophosphatemia

		Mean nadir phosphate, mg/dLa			Mean INRa			Length of stay, d			Post-hepatectomy liver failure			Any morbidity			30 d mortality
No	Ref.	PHH	NP	P value	PHH	NP	P value	PHH	NP	P value	PHH	NP	P value	PHH	NP	P value	PHH	NP	P value
1	Buell et al[14], 1998	2.1 ± 0.1b	3.0 ± 0.2b	< 0.05	NR			16.22 ± 12.09	11.22 ± 7.03	NR	NR			17/21 (81)	4/14 (29)	< 0.05	1/21 (5)	0/14 (0)	NR
2	George et al[11], 1992	NR			NR			NR			1/44 (2)	0/0	NA	11/44 (25)	0/0 (0)	NA	NR
3	Giovannini et al[12], 2002	1.7 ± 0.8 (POD3)		NR	NR			NR			NR			Mild-moderate: 4/23 (17) Severe: 9/15 (60)	3/21 (14)	< 0.001c	Mild-moderate: 1/23 (4) Severe: 3/12 (20)	1/21 (5)	NR
4	Hallet et al[10], 2016	1.52 ± 0.31d	2.72 ± 0.74d	< 0.01	1.51 ± 0.37	1.53 ± 0.91	0.83	7 (6-10)	7 (5-11)	0.55	44/223 (19.7)	20/179 (11.2)	0.02	Major morbidity: 13/223 (5.8)	Major morbidity: 12/179 (6.7)	0.56	9/223 (4.0)	4/179 (2.2)	0.31
5	Serrano et al[38], 2019	2.00e (recorded at median 1.6 d post-operatively)			NR			7.2 ± 3.4e		NR	10/161 (6.2)		NR	Any morbidity > 30 d: 19/161 (11.8)		NR	NR
6	Squires et al[13], 2014	2.2 [1.7-2.8]			NR			NR			Moderate: 8.0% Severe: 8.5% Profound: 3.4%f	12.3%f	0.008	Major morbidity: Moderate: 20.1% Severe: 19.5% Profound: 16.7%f	30.3%f	0.037	Moderate: 3.8% Severe: 2.8% Profound: 0%	6.5%	0.010
7	Tan et al[39], 2003	2.6 (range 1.3-5.0)		NR	NR			NR			NR			Any morbidity: 8/95 (8.4)		NR	NR
8	Yuan et al[40], 2010	1.89 ± 0.72 (POD3)		NR	Mild: 1.51 ± 0.26 Moderate: 1.43 ± 0.19 Severe: 1.95 ± 0.40	NR	< 0.001g	NR			14/100 (14)	0/2 (0)	NR	NR			NR

^aValues are reported on post-operative day 2 unless otherwise specified.

^bValues described here excluded patients who received cryosurgery; the study included cohort of patients who received both major hepatectomy and cryosurgery.

^cComparing severe PHH (< 1.5 mg/dL) with other range of phosphate values.

^dValues were reported in mmol/L in the original study and subsequently converted to mmol/L for standardization.

^eOverall mean and SD was calculated through the combination of mean and SD from patients who had liver insufficiency and those without using methods described by Michael et al[37].

^fExact values of patients with normal, moderate, severe and profound post-hepatectomy hypophosphatemia (PHH) were not provided in the study.

^gComparing between each subgroup of PHH. All categorical variables are expressed as n (%), and all continuous variables are expressed in median (range), median [IQR], or mean ± SD unless otherwise specified. NA: Not applicable; NP: Normophosphatemia; NR: Not reported; PHH: Post-hepatectomy hypophosphatemia; POD: Post-operative day; SD: Standard deviation.