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©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Jan 7, 2014; 20(1): 274-281
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.274
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.274
Table 1 Liver disease etiologies among the enrolled patients (n = 478)
Etiology | n (%) |
Malignant disease | 371 (77.6) |
HCC | 323 (67.6) |
Colorectal metastasis | 25 (5.2) |
Other metastatic disease | 12 (2.5) |
Cholangiocarcinoma | 9 (1.9) |
Gallbladder carcinoma | 2 (0.4) |
Benign disease | 107 (22.4) |
HCH | 72 (15.1) |
FNH | 13 (2.7) |
Hepatic echinococcosis | 7 (1.5) |
Hepatic complex cysts | 2 (0.4) |
Adenoma | 9 (1.9) |
Cystadenoma | 3 (0.6) |
Table 2 Postoperative complications in the entire patient cohort (n = 478)
Complication | n (%) |
Cardiopulmonary | 90 (18.8) |
Myocardial infarction | 4 (0.8) |
Cardiac arrest | 15 (3.1) |
Congestive heart failure | 6 (1.3) |
Respiratory insufficiency/failure1 | 12 (2.5) |
Pneumonia | 34 (7.1) |
Pleural effusion (symptomatic) | 19 (4.0) |
Liver/biliary | 70 (14.6) |
Increased bilirubin2 | 59 (12.3) |
Bile leak/biloma | 5 (1.0) |
Cholangitis | 6 (1.3) |
Gastrointestinal | 12 (2.5) |
Ileus | 5 (1.0) |
Gastrointestinal hemorrhage | 7 (1.5) |
Infection | 34 (7.1) |
Deep wound infection | 23 (4.8) |
Sepsis/bacteremia | 11 (2.3) |
Renal and genitourinary | 59 (12.3) |
Renal insufficiency/failure | 17 (3.6) |
Urinary tract infection | 23 (4.8) |
Urinary retention | 19 (4.0) |
Miscellaneous | 23 (4.8) |
Deep venous thrombosis | 5 (1.0) |
Need for reoperation | 7 (1.5) |
Perioperative hemorrhage | 11 (2.3) |
Others3 | 10 (2.1) |
Table 3 Diagnostic characteristics of total bilirubin, international normalized ratio and combined criteria on postoperative day (3, 5, 7) in the prediction of liver failure-related death
Criteria | AUC | 95%CI | Sensitivity | Specificity | P value | Cut-off value |
POD 3 | ||||||
TBIL-r1 | 0.686 | 0.642-0.727 | 92.90% | 51.70% | 0.018 | 1.24 |
INR-r1 | 0.658 | 0.614-0.701 | 64.30% | 64.90% | 0.046 | 0.94 |
Combination1 | 0.719 | 0.676-0.759 | 64.30% | 74.80% | 0.005 | 0.0337 |
POD 5 | ||||||
TBIL-r1 | 0.918 | 0.890-0.941 | 85.70% | 87.50% | 1.0e-7 | 1.68 |
INR-r1 | 0.719 | 0.677-0.759 | 50.00% | 94.80% | 0.006 | 1.02 |
Combination1 | 0.951 | 0.927-0.968 | 92.90% | 90.10% | 9.0e-9 | 0.0379 |
TBIL | 0.810 | 0.772-0.844 | 78.60% | 81.50% | 7.7e-5 | 51.0 |
INR | 0.708 | 0.665-0.748 | 85.70% | 64.40% | 0.008 | 1.23 |
Combination2 | 0.829 | 0.792-0.861 | 99.80% | 57.50% | 2.8e-5 | 0.0164 |
POD 7 | ||||||
TBIL-r1 | 0.937 | 0.912-0.957 | 85.70% | 91.60% | 2.4e-8 | 1.61 |
INR-r1 | 0.796 | 0.757-0.831 | 71.40% | 80.00% | 1.5e-4 | 0.91 |
Combination1 | 0.975 | 0.956-0.987 | 92.90% | 94.40% | 1.4e-9 | 0.0566 |
TBIL | 0.886 | 0.854-0.913 | 92.90% | 79.10% | 1.0e-6 | 49.5 |
INR | 0.798 | 0.760-0.833 | 85.70% | 73.30% | 1.4e-4 | 1.22 |
Combination2 | 0.908 | 0.879-0.933 | 92.90% | 79.70% | 8.7e-7 | 0.0277 |
Table 4 Univariate analysis of factors associated with the hepatic damage score (n = 478)
Variable | Group 1 (n = 380) | Group 2 (n = 98) | t | χ2 | P value |
Age (yr) | 47.5 ± 12.4 | 46.2 ± 11.4 | 0.946 | 0.345 | |
Gender | 0.639 | 0.424 | |||
Male | 306 | 83 | |||
Female | 72 | 15 | |||
TBIL (µmol/L)1 | 17.5 ± 6.2 | 18.6 ± 5.7 | -1.516 | 0.130 | |
ALB (g/L)1 | 40.0 ± 5.0 | 39.6 ± 5.0 | 0.737 | 0.462 | |
ALT (IU/L)1 | 55 ± 47 | 54 ± 30 | 0.117 | 0.907 | |
AST (IU/L)1 | 60 ± 54 | 64 ± 41 | -0.557 | 0.578 | |
CREA (µmol/L)1 | 0.92 ± 0.28 | 0.94 ± 0.27 | -0.692 | 0.489 | |
ICG R15 (%)1 | 7.2 ± 4.3 | 8.7 ± 5.5 | -2.598 | 0.010 | |
INR1 | 1.09 ± 0.10 | 1.07 ± 0.11 | 1.305 | 0.192 | |
HBsAg1 | 0.201 | 0.654 | |||
Positive | 268 | 72 | |||
Negative | 112 | 26 | |||
CTP grade1 | 7.735 | 0.007 | |||
A | 351 | 81 | |||
B | 29 | 17 | |||
MELD score1 | 5.8 ± 3.8 | 6.2 ± 3.4 | -0.981 | 0.327 | |
IBL (mL) | 731 ± 790 | 972 ± 953 | -2.309 | 0.022 | |
IBT (mL) | 427 ± 764 | 649 ± 943 | -2.157 | 0.033 | |
RS | 2.4 ± 1.0 | 3.8 ± 1.4 | -9.852 | 2. 0e-17 |
Table 5 Multivariate analysis of the hepatic damage score
Variable | β | SE | Wald | P value | Exp (β) | 95%CI | |
Lower | Upper | ||||||
ICG-R15 | 0.176 | 0.03 | 35.080 | 3.2e-9 | 1.192 | 1.125 | 1.263 |
RS | 1.292 | 0.142 | 83.158 | 7.6e-20 | 3.639 | 2.757 | 4.803 |
- Citation: Du ZG, Wei YG, Chen KF, Li B. An accurate predictor of liver failure and death after hepatectomy: A single institution’s experience with 478 consecutive cases. World J Gastroenterol 2014; 20(1): 274-281
- URL: https://www.wjgnet.com/1007-9327/full/v20/i1/274.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i1.274