Nomogram based on liver stiffness and spleen area with ultrasound for posthepatectomy liver failure: A multicenter study

Table 1 Descriptive characteristics of the study population, n (%)

Characteristics	Training cohort	Validation cohort	P value
Patients	500	62
PHLF	142 (28.40)	22 (35.50)	0.250
Sex			0.080
Male	413 (89.01)	45 (72.58)
Female	87 (10.99)	17 (27.42)
Age in yr, mean ± SD	55.70 ± 10.70	53.05 ± 10.62	0.067
TB in mg/dL, median; IQR	12.8; 9.9-17.0	13.4; 9.2-17.2	0.740
ALB in g/L, median; IQR	43; 40.0-46.0	41; 38.8-45.0	0.130
ALT in U/L, median; IQR	27; 19.0-38.0	32; 21.0-39.0	0.250
PT in s, median; IQR	12.4; 11.7-13.2	12.0; 11.5-13.0	0.080
INR, median; IQR	10.5; 9.9-11.1	10.2; 9.7-10.9	0.110
PLT as × 109/L, median; IQR	148.5; 111.0-197.0	167.5; 139.8-192.0	0.060
GGT in U/L, median; IQR	43.0; 11.0-1019.0	44.5; 16.0-543.0	0.190
WBC as × 109, median; IQR	5.55; 1.84-14.07	5.88; 2.01-14.30	0.250
HB in g/L, median; IQR	142; 66-203	145; 105-267	0.200
AFP			0.680
≤ 20	239 (47.8)	27 (43.5)
> 20	261 (52.2)	35 (56.5)
LS in kPa, median; IQR	10.8; 7.9-14.0	9.6; 8.0-12.3	0.150
SPA in cm2, median; IQR	38.70; 38.50-41.10	39.16; 37.90-44.80	0.370
Tumor size in cm, median; IQR	3.1; 0.5-25.0	3.8; 0.7-13.0	0.230
Tumor number, median; IQR	1; 1.0-15.0	1; 1.0-2.0	0.090
RR			0.070
Minor	400 (80.0)	43 (69.4)
Major	100 (20.0)	19 (30.6)
BL in mL, median; IQR	100; 50-200	175; 50-300	0.390
Clamping time in min, median; IQR	15.0; 0-69	13.5; 0-60	0.150
HBV			0.570
Positive	468 (93.6)	60 (96.7)
Negative	32 (6.4)	2 (3.3)
HBV-DNA level			0.680
≥ 103 IU/mL	286 (57.2)	32 (51.6)
< 103 IU/mL	32 (42.8)	30 (48.4)
PHLF			0.250
Absent	358 (71.6)	40 (64.5)
Present	142 (28.4)	22 (35.5)
PHLF ISGLS grade			0.310
0-A	464 (92.8)	55 (88.7)
B-C	36 (7.2)	7 (11.3)

Data in parentheses were used to calculate percentages. AFP: Alpha-fetoprotein; ALB: Albumin; ALT: Alanine transaminase; BL: Blood loss; GGT: γ-glutamyl transpeptidase; HB: Hemoglobin; HBV: Hepatitis B virus; INR: International normalized ratio, multiplied by 10; IQR: Interquartile range; ISGLS: International Study Group on Liver Surgery; LS: Liver stiffness; PHLF: Posthepatectomy liver failure; PLT: Platelet; PT: Prothrombin time; RR: Range of resection; SD: Standard deviation; SPA: Spleen area; TB: Total bilirubin; WBC: White blood cell.

Table 2 Comparison of model discrimination

Variables	Training cohort, n = 500			Validation cohort, n = 62
Model	PM	ALBI	MELD	PM	ALBI	MELD
AUC (95%CI)	0.833 (0.792-0.873)	0.651 (0.598-0.703)	0.508 (0.436-0.548)	0.802 (0.684-0.920)	0.658 (0.536-0.774)	0.631 (0.499-0.750)
Sensitivity, %	83.100 (118/142)	43.700 (62/142)	62.000 (88/142)	95.500 (21/22)	72.300 (13/22)	59.100 (13/22)
Specificity, %	73.500 (263/358)	80.200 (287/358)	53.100 (190/358)	52.500 (21/40)	57.500 (29/40)	72.500 (29/40)
P value	-	< 0.0011	< 0.0012	-	0.0403	0.0484

¹Area under receiver operating characteristic curve (AUC) values of the albumin-bilirubin (ALBI) score compared to that of the posthepatectomy liver failure model (PM) in the training cohort.

²AUC values of the model for end-stage liver disease (MELD) score compared to that of the PM in the training cohort.

³AUC values of the ALBI score compared to that of the PM in the validation cohort.

⁴AUC values of the model for end-stage liver disease score compared to that of the PM in the validation cohort.

CI: Confidence interval.