Postoperative survival analysis and prognostic nomogram model for patients with portal hypertension

Table 1 Patient demographics, laboratory information and perioperative characteristics (n = 319) n (%)

Parameter	STPD (n = 200)	SSPD (n = 119)	P value
Age (yr)	49.79 ± 11.14	48.92 ± 10.09	0.49
Gender (male)	93 (46.50)	54 (45.38)	0.85
Aetiology: Hepatitis B/hepatitis C/others	131 (65.50)/23 (11.50)/46 (23.00)	88 (73.95)/17 (14.29)/14 (11.76)	0.04
Charlson score: 0/1/2/3/≥ 3	105 (52.50)/54 (27.00)/21 (10.50)/ 20 (10.00)	62 (52.10)/42 (35.29)/12 (10.08)/3 (2.52)	0.06
Blood type: A/B/O/AB	57 (28.50)/62 (31.00)/59 (29.50)/22 (11.00)	36 (30.25)/33 (27.73)/36 (30.25)/14 (11.76)	0.94
History of variceal ligation	27 (13.50)	9 (7.56)	0.11
History of abdominal surgery	35(17.50)	21(17.65)	0.97
Smoking	57 (28.50)	28 (23.53)	0.33
Drinking	38 (19.00)	25 (21.01)	0.66
History of variceal bleeding	105 (52.50)	43 (36.13)	0.01
BMI	21.97 ± 3.04	21.62 ± 2.54	0.29
Child-Pugh score	6.56 ± 1.27	6.92 ± 1.29	0.02
MELD score	5.92 ± 0.40	5.97 ± 0.47	0.32
ALBI score	-2.26 ± 0.50	-2.10 ± 0.54	0.01
CCI score	18.64 ± 11.78	17.53 ± 9.53	0.38
WBC count (109/L)	2.79 ± 1.78	2.40 ± 1.38	0.04
Hb (g/L)	93.35 ± 24.77	94.74 ± 25.82	0.63
Platelet count (109/L)	49.32 ± 28.63	43.28 ± 21.20	0.05
PT (s)	13.85 ± 1.96	14.29 ± 1.82	0.04
INR	1.19 ± 0.18	1.32 ± 1.10	0.10
TBIL (mmol/L)	27.24 ± 16.22	29.37 ± 16.81	0.26
DBIL (mmol/L)	11.87 ± 7.67	12.33 ± 6.87	0.59
ALT (IU/L)	35.79 ± 55.76	38.20 ± 31.58	0.67
AST (IU/L)	43.72 ± 52.72	44.55 ± 33.76	0.88
ALB (g/L)	37.24 ± 5.50	35.61 ± 5.66	0.01
GLB (g/L)	28.36 ± 5.90	29.03 ± 5.91	0.32
Scr (mmol/L)	62.44 ± 18.02	58.71 ± 13.68	0.05
Cys C (mg/L)	1.12 ± 0.32	1.11 ± 0.25	0.71
Duration of preoperative hospital stay (d)	14.56 ± 9.43	16.08 ± 9.29	0.16
Duration of postoperative hospital stay (d)	15.75 ± 6.46	14.97 ± 5.30	0.27
Total hospital stay (d)	30.61 ± 12.20	31.77 ± 11.75	0.40
Operative time, min	139.76 ± 50.73	124.55 ± 42.49	0.00
Intraoperative blood loss (mL)	869.51 ± 692.77	591.34 ± 477.54	0.00
Time to first flatus (d)	4.69 ± 1.70	3.67 ± 1.18	0.00

BMI: Body mass index; MELD: Model for end-stage liver disease; ALBI: Albumin-bilirubin; CCI: Comprehensive Complication Index; WBC: White blood cell; Hb: Haemoglobin; PT: Prothrombin time; INR: International normalised ratio; TBIL: Total bilirubin; DBIL: Direct bilirubin; ALT: Alanine transaminase; AST: Aspartate transaminase; ALB: Albumin; GLB: Globulin; Scr: Serum creatinine; Cys C: Cystatin C; SSPD: Splenectomy plus simplified pericardial devascularisation.

Table 2 Univariate Cox regression analysis of overall survival, bleeding-free survival and disease-specific survival

Parameter	OS				BFS				DSS
	B	P value	RR	95%CI	B	P value	RR	95%CI	B	P value	RR	95%CI
Type of operation	0.16	0.62	1.18	0.62-2.23	-0.39	0.33	0.68	0.31-1.48	-0.45	0.17	0.64	0.34-1.21
CCI	0.04	0.00	1.04	1.01-1.07	0.02	0.36	1.02	0.98-1.05	0.06	0.00	1.06	1.02-1.09
Gender	0.01	0.99	1.01	0.54-1.89	0.94	0.02	2.56	1.20-5.43	0.06	0.91	1.06	0.43-2.60
Age	0.06	0.00	1.06	1.03-1.09	0.04	0.01	1.05	1.01-1.08	0.05	0.00	1.05	1.02-1.09
Aetiology	0.07	0.74	1.07	0.73-1.56	0.16	0.44	1.18	0.78-1.78	-0.16	0.43	0.86	0.58-1.26
History of variceal ligation	0.75	0.10	2.12	0.87-5.19	1.07	0.01	2.92	1.24-6.88	0.54	0.21	1.72	0.73-4.02
History of abdominal surgery	0.33	0.42	1.39	0.63-3.03	0.16	0.73	1.17	0.48-2.87	-1.28	0.20	0.28	0.04-1.96
Smoking	0.45	0.19	1.56	0.80-3.04	0.54	0.15	1.72	0.82-3.60	0.27	0.55	1.31	0.55-3.11
Drinking	0.17	0.65	1.19	0.56-2.51	0.71	0.07	2.04	0.96-4.33	-0.12	0.81	0.89	0.34-2.35
Charlson Score	0.11	0.53	1.12	0.80-1.56	0.02	0.93	1.02	0.69-1.51	0.06	0.77	1.06	0.72-1.58
History of variceal bleeding	0.07	0.82	1.08	0.57-2.03	1.02	0.01	2.77	1.30-5.90	-0.30	0.43	0.74	0.36-1.55
Blood type	-0.20	0.25	0.82	0.58-1.15	-0.15	0.41	0.86	0.60-1.23	-0.16	0.29	0.85	0.63-1.15
BMI	-0.06	0.34	0.94	0.83-1.07	0.00	0.97	1.00	0.88-1.14	-0.03	0.57	0.97	0.86-1.09
Total hospital stay	0.01	0.36	1.01	0.99-1.04	0.00	0.79	1.00	0.98-1.03	-0.03	0.26	0.97	0.93-1.02
Duration of preoperative hospital stay	0.01	0.43	1.01	0.98-1.05	0.01	0.59	1.01	0.97-1.05	0.04	0.20	1.04	0.98-1.09
Duration of postoperative hospital stay	0.03	0.20	1.03	0.98-1.09	-0.01	0.71	0.99	0.92-1.06	0.00	0.91	1.00	0.94-1.08
Operative time	0.01	0.00	1.01	1.00-1.02	0.01	0.04	1.01	1.00-1.02	0.00	0.33	1.00	1.00-1.01
Intraoperative blood loss	0.00	0.01	1.00	1.00-1.01	0.00	0.00	1.00	1.00-1.01	0.00	0.09	1.00	1.00-1.00
Time to first flatus	-0.01	0.94	0.99	0.81-1.21	0.23	0.03	1.26	1.03-1.53	-0.06	0.57	0.94	0.78-1.15
WBC count	0.20	0.03	1.22	1.02-1.45	0.15	0.13	1.16	0.96-1.41	-0.02	0.88	0.98	0.80-1.21
Hb	-0.01	0.04	0.99	0.97-1.00	-0.02	0.04	0.99	0.97-1	-0.01	0.31	0.99	0.97-1.01
Platelet count	0.01	0.08	1.01	1.00-1.02	0.01	0.01	1.01	1.00-1.02	0.01	0.05	1.01	1.00-1.03
PT	0.07	0.46	1.07	0.90-1.27	-0.08	0.44	0.92	0.74-1.14	-0.26	0.75	0.77	0.16-3.66
INR	-0.03	0.93	0.97	0.51-1.83	-0.93	0.44	0.39	0.04-4.29	-1.80	0.84	0.17	0.00-9821579.13
TBIL	0.01	0.22	1.01	0.99-1.03	-0.01	0.45	0.99	0.97-1.02	0.00	0.97	1.00	0.96-1.04
DBIL	0.02	0.20	1.02	0.99-1.06	-0.03	0.34	0.97	0.92-1.03	0.02	0.72	1.02	0.93-1.12
ALT	0.00	0.00	1.00	1.00-1.01	-0.01	0.35	0.99	0.98-1.01	0.01	0.12	1.02	1.00-1.03
AST	0.00	0.01	1.00	1.00-1.01	-0.02	0.10	0.98	0.96-1.00	-0.01	0.27	0.99	0.97-1.01
ALB	-0.11	0.00	0.90	0.84-0.96	-0.03	0.45	0.98	0.91-1.04	-0.39	0.25	0.68	0.35-1.31
GLB	0.02	0.53	1.02	0.96-1.07	-0.07	0.04	0.93	0.87-1.00	0.03	0.28	1.03	0.97-1.10
Scr	0.01	0.32	1.01	0.99-1.03	0.02	0.07	1.02	1.00-1.03	-0.08	0.01	0.93	0.87-0.98
Cys C	0.71	0.09	2.03	0.91-4.57	0.23	0.67	1.26	0.44-3.66	1.17	0.02	3.21	1.20-8.62
Child-Pugh score	0.29	0.01	1.33	1.08-1.65	0.13	0.36	1.13	0.87-1.48	0.14	0.54	1.15	0.74-1.81
MELD score	0.50	0.18	1.64	0.80-3.40	0.02	0.97	1.02	0.44-2.36	4.18	0.05	65.31	0.94-4536.32
ALBI score	1.07	0.00	2.92	1.49-5.76	0.19	0.59	1.21	0.60-2.46	-3.86	0.33	0.02	0.00-48.67

OS: Overall survival; BFS: Bleeding-free survival; CCI: Comprehensive Complication Index; BMI: Body mass index; WBC: White blood cell; Hb: Haemoglobin; PT: Prothrombin time; INR: International normalised ratio; TBIL: Total bilirubin; DBIL: Direct bilirubin; ALT: Alanine transaminase; AST: Aspartate transaminase; ALB: Albumin; GLB: Globulin; Scr: Serum creatinine; Cys C: Cystatin C; MELD: Model for end-stage liver disease; ALBI: Albumin-bilirubin; B: Regression coefficient; SE: Standard error; RR: Relative risk; CI: Confidence interval.

Table 3 Multivariate Cox regression analysis of overall survival and bleeding free survival

Parameter	B	SE	P value	RR	95%CI
OS
Age	0.06	0.02	0.00	1.06	1.03-1.09
Operative time	0.01	0.00	0.01	1.01	1.00-1.02
ALT	0.01	0.00	0.00	1.01	1.00-1.01
ALBI score	1.03	0.37	0.01	2.79	1.36-5.72
BFS
Male	1.17	0.40	0.00	3.22	1.48-7.01
Age	0.05	0.02	0.01	1.05	1.01-1.09
Intraoperative blood loss	0.00	0.00	0.05	1.00	1.00-1.01
Time to first flatus	0.23	0.10	0.02	1.26	1.04-1.53
DSS
CCI	0.06	0.01	0.00	1.06	1.05-1.08
Age	0.04	0.01	0.00	1.04	1.02-1.06

ALT: Alanine transaminase; ALBI: Albumin-bilirubin; B: Regression coefficient; SE: Standard error; RR: Relative risk; CI: Confidence interval.