Risk factors and predictive modeling of early postoperative liver function abnormalities

Table 1 General information of the normal and abnormal groups, n (%)

Parameter	Normal group (n = 3553)	Abnormal group (n = 167)	Statistic	P value
Gender, male	1037 (29.19)	88 (52.69)	χ² = 41.78	< 0.01
Age, year	56.00 (47.00, 66.00)	59.00 (50.00, 67.00)	Z = -1.51	0.13
Weight, kg	58.00 (52.00, 65.00)	59.00 (52.35, 66.50)	Z = -0.93	0.35
BMI, kg/m2	22.89 (20.62, 25.33)	22.66 (20.37, 25.56)	Z = -0.31	0.76
Past medical history
High blood pressure	1126 (31.69)	51 (30.54)	χ² = 0.10	0.75
Diabetes	2487 (70.00)	116 (69.46)	χ² = 0.02	0.88
Coronary heart disease	1480 (41.65)	72 (43.11)	χ² = 0.14	0.71
Cerebral infarction	90 (2.53)	2 (1.20)	χ² = 0.69	0.41
Viral hepatitis	211 (5.94)	13 (7.78)	χ² = 0.96	0.33
Chronic hepatitis	17 (0.48)	1 (0.60)	-	0.56
Liver cirrhosis	12 (0.34)	0 (0.00)	-	1.00
Hyperlipidemia	140 (3.94)	10 (5.99)	χ² = 1.73	0.19
COPD	11 (0.31)	1 (0.60)	-	0.42
Chronic kidney disease	91 (2.56)	6 (3.59)	χ² = 0.32	0.57

BMI: Body mass index; COPD: Chronic obstructive pulmonary disease.

Table 2 Results of laboratory testing analysis in the normal and abnormal groups

Parameter, unit	Normal group (n = 3553)	Abnormal group (n = 167)	Statistic	P value
AST, U/L	18.00 (15.00, 22.00)	30.00 (20.00, 52.00)	Z = -12.42	< 0.01
ALT, U/L	15.00 (11.00, 21.00)	29.00 (17.00, 69.00)	Z = -10.83	< 0.01
ALP, g/L	70.00 (57.00, 87.00)	78.00 (63.64, 111.00)	Z = -4.78	< 0.01
GGT, U/L	19.00 (14.00, 30.00)	38.00 (21.00, 82.50)	Z = -9.77	< 0.01
Tbil, μmol/L	8.60 (6.00, 12.10)	10.30 (7.10, 15.60)	Z = -4.23	< 0.01
Total protein, g/L	71.30 (68.80, 74.60)	70.90 (67.05, 72.70)	Z = -3.35	< 0.01
Albumin, g/L	42.90 (40.20, 45.50)	41.50 (38.20, 44.45)	Z = -4.23	< 0.01
Globulin, g/L	27.20 (25.70, 30.40)	27.20 (25.50, 30.60)	Z = -0.45	0.65
Glu, mmol/L	5.31 (4.78, 6.36)	5.77 (5.00, 6.88)	Z = -3.11	< 0.01
HB, g/L	125.00 (109.00, 136.00)	125.00 (106.50, 140.50)	Z = -0.90	0.37
WBC, × 109/L	6.35 (5.27, 7.72)	6.37 (5.30, 7.94)	Z = -0.53	0.60
N, × 109/L	3.94 (3.07, 5.08)	3.92 (2.90, 5.13)	Z = -0.28	0.78
RBC, × 1012/L	4.33 (3.95, 4.68)	4.26 (3.74, 4.68)	Z = -1.85	0.06
PLT, × 1012/L	259.00 (215.00, 314.00)	232.00 (178.00, 278.00)	Z = -4.72	< 0.01
K+ , mmol/L	4.00 (3.80, 4.20)	4.01 (3.77, 4.21)	Z = -0.14	0.89
Na+ , mmol/L	140.00 (139.00, 142.00)	140.00 (139.00, 142.00)	Z = -1.20	0.23
Ca2+ , mmol/L	2.30 (2.30, 2.30)	2.30 (2.30, 2.30)	Z = -0.05	0.96
CL- , mmol/L	103.80 (102.10, 105.50)	103.70 (101.60, 105.40)	Z = -0.86	0.39
TC, mmol/L	4.71 (4.49, 4.91)	4.71 (4.46, 4.75)	Z = -0.42	0.67
Tg, mmol/L	1.35 (1.19, 1.45)	1.35 (1.29, 1.60)	Z = -1.29	0.20
LDL, mmol/L	3.06 (2.87, 3.20)	3.06 (2.79, 3.06)	Z = -1.14	0.25
HDL, mmol/L	1.18 (1.14, 1.26)	1.18 (0.99, 1.18)	Z = -2.96	< 0.01
Uric, mmol/L	350.00 (350.00, 350.00)	350.00 (350.00, 350.00)	Z = -0.74	0.46
EGFR, mmol/L	94.75 (81.14, 106.41)	93.72 (83.34, 104.34)	Z = -0.20	0.84
Urea, mmol/L	4.68 (3.72, 5.75)	4.81 (3.91, 5.81)	Z = -0.97	0.33
Cr, mmol/L	65.00 (56.00, 78.00)	69.00 (58.00, 83.00)	Z = -1.98	0.05

ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; EGFR: Epidermal growth factor receptor; GGT: Gamma-glutamyl transpeptidase; HB: Hemoglobin; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; PLT: Platelets; RBC: Red blood cells; TBIL: Total bilirubin; WBC: White blood cells; Glu: Glucose; Cr: Creatinine.

Table 3 Intraoperative data analysis for the normal and abnormal groups

Parameter	Normal group (n = 3553)	Abnormal group (n = 167)	Statistic	P value
Head and neck surgery	14 (0.39)	3 (1.80)	-	0.04
Operation on the spine and limbs	643 (18.10)	42 (25.15)	χ² = 5.28	0.02
Operation on the esophagus, gastrointestinal tract, pancreas, spleen, and appendix	907 (25.53)	88 (52.69)	χ² = 60.08	< .01
Operation on the kidneys, bladder, and ureter	218 (6.14)	8 (4.79)	χ² = 0.51	0.48
Operation on the uterus, ovaries, and fallopian tube	1771 (49.85)	26 (15.57)	χ² = 75.04	< 0.01
Time of operation	239.00 (205.00, 288.00)	290.00 (232.00, 359.00)	Z = -7.16	< 0.01
Anesthesia time, minute	295.00 (257.00, 346.00)	352.00 (290.00, 417.00)	Z = -7.50	< 0.01
Length of hospital stay, day	13.00 (9.00, 18.00)	16.00 (11.00, 22.00)	Z = -5.24	< 0.01
ASA rating
I	169 (4.76)	5 (2.99)	χ² = 1.11	0.29
II	2709 (76.25)	115 (68.86)	χ² = 4.76	0.03
III	671 (18.89)	45 (26.95)	χ² = 6.67	< 0.01
IV	4 (0.11)	2 (1.20)	-	0.03
Sufentanil, μg	10.00 (5.00, 15.00)	10.00 (5.00, 15.00)	Z = -1.31	0.19
Whether to pump remifentanil	3131 (88.12)	164 (98.20)	χ² = 16.02	< 0.01
Rocuronium, mg	2.49 ± 10.76	2.94 ± 10.66	t = -0.53	0.59
Etomidate, mg	6.88 ± 16.13	8.70 ± 19.38	t = -1.41	0.16
Whether to pump propofol	2681 (75.46)	119 (71.26)	χ² = 1.51	0.22
Dosage of intravenous propofol, mg	35.40 ± 153.54	30.48 ± 107.01	t = 0.41	0.68
Dexmedetomidine, μg	4.09 ± 12.96	3.92 ± 13.37	t = 0.17	0.87
Sevoflurane, mL	60.00 (40.00, 100.00)	80.00 (50.00, 120.00)	Z = -4.29	< 0.01

ASA: American Society of Anesthesiologists.

Table 4 Results of the logistic regression analysis

Parameter	β	Se	Wald χ2	P value	Or	Lower limit of 95%CI	95%CI upper bound
Age, year	-0.011	0.007	2.018	0.155	0.989	0.975	1.004
Sex, male	-0.043	0.227	0.035	0.851	0.958	0.614	1.495
Anesthesia time, minute	0.005	0.001	25.564	0	1.005	1.003	1.007
ASA II	-0.027	0.215	0.016	0.899	0.973	0.638	1.483
Whether to pump remifentanil	1.528	0.623	6.023	0.014	4.610	1.360	15.624
Cr, mmol/L	-0.002	0.003	0.508	0.476	0.998	0.992	1.004
Sufentanil	0.008	0.002	16.397	0.00	1.008	1.004	1.012
AST, U/L	0.042	0.009	21.633	0.00	1.043	1.025	1.062
ALT, U/L	0.019	0.006	9.411	0.002	1.019	1.007	1.031
ALP, g/L	-0.002	0.002	0.371	0.543	0.998	0.994	1.003
GGT, U/L	0.003	0.002	3.397	0.065	1.003	1.00	1.007
TBIL, μmol/L	0.015	0.011	1.907	0.167	1.015	0.994	1.037
Albumin, g/L	-0.013	0.021	0.385	0.535	0.987	0.946	1.029
PLT, × 1012/L	-0.004	0.001	10.624	0.001	0.996	0.994	0.999
Glu, mmol/L	0.011	0.041	0.078	0.78	1.012	0.934	1.096
Length of hospital stay, day	0.014	0.008	3.37	1	0.066	1.014	0.999
Operation on the esophagus, gastrointestinal tract, pancreas, spleen, and appendix	0.824	0.229	12.988	0.00	2.279	1.456	3.567
Operation on the uterus, ovaries, and fallopian tube	-0.773	0.310	6.231	0.013	0.461	0.251	0.847
Constant	-6.847	1.46	22.009	0.00	0.001

ASA: American Society of Anesthesiologists; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Gamma-glutamyl transpeptidase; PLT: Platelets; Glu: Glucose; TBIL: Total bilirubin; Cr: Creatinine.