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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Interaction between the albumin-bilirubin score and nutritional risk index in the prediction of post-hepatectomy liver failure
Feng-Fei Qin, Feng-Lian Deng, Cui-Ting Huang, Shu-Li Lin, Hui Huang, Jie-Jin Nong, Mei-Juan Wei
Feng-Fei Qin, Feng-Lian Deng, Hui Huang, Department of Infectious Diseases, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Cui-Ting Huang, Department of Renal Diseases, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Shu-Li Lin, School of Nursing, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Jie-Jin Nong, Department of Interventional Oncology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Mei-Juan Wei, Department of Radiation Oncology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Co-first authors: Feng-Fei Qin and Feng-Lian Deng.
Co-corresponding authors: Jie-Jin Nong and Mei-Juan Wei.
Author contributions: Qin FF and Deng FL, as co-first authors, designed and performed the research and wrote the manuscript; Huang CT and Lin SL collected experimental data and conducted statistical analyses; Huang H collected pathological specimens; Nong JJ and Wei MJ, as co-corresponding authors, provided funding and administrative support, provided guidance for the research, and revised the manuscript.
Supported by the Fourth Batch of Self-funded Projects of the Baise Scientific Research and Technology Development Plan in 2022, No. 20223734; and the 2023 National Key Research and Development Program: Research on Susceptibility Mechanisms and Screening Key Technologies for Major Viral Diseases, No. 2023YFC2605400.
Institutional review board statement: This study was approved by the Affiliated Hospital of Youjiang Medical University for Nationalities Institutional Review Committee.
Informed consent statement: This study was exempt from the requirement for informed consent due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Raw data for this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Jie-Jin Nong, MBBS, Nurse, Department of Interventional Oncology, The Affiliated Hospital of Youjiang Medical University for Nationalities, No. 18 Zhongshan Second Road, Youjiang District, Baise 533000, Guangxi Zhuang Autonomous Region, China.
jiejinnong@163.com
Received: April 1, 2024
Revised: May 11, 2024
Accepted: June 4, 2024
Published online: July 27, 2024
Processing time: 111 Days and 22.5 Hours
BACKGROUND
Post-hepatectomy liver failure (PHLF) is the most common postoperative complication and the leading cause of death after hepatectomy. The albumin-bilirubin (ALBI) score and nutritional risk index (NRI) have been shown to assess end-stage liver disease and predict PHLF and patient survival. We hypothesized that the ALBI score and NRI interact in the prediction of PHLF.
AIM
To analyze the interaction between the ALBI score and NRI in PHLF in patients with hepatocellular carcinoma.
METHODS
This retrospective study included 186 patients who underwent hepatectomy for hepatocellular carcinoma at the Affiliated Hospital of Youjiang Medical University for Nationalities between January 2020 and July 2023. Data on patient characteristics and laboratory indices were collected from their medical records. Univariate and multivariate logistic regression were performed to determine the interaction effect between the ALBI score and NRI in PHLF.
RESULTS
Of the 186 patients included in the study, PHLF occurred in 44 (23.66%). After adjusting for confounders, multivariate logistic regression identified ALBI grade 2/3 [odds ratio (OR) = 73.713, 95% confidence interval (CI): 9.175-592.199] and NRI > 97.5 (OR = 58.990, 95%CI: 7.337-474.297) as risk factors for PHLF. No multiplicative interaction was observed between the ALBI score and NRI (OR = 0.357, 95%CI: 0.022-5.889). However, the risk of PHLF in patients with ALBI grade 2/3 and NRI < 97.5 was 101 times greater than that in patients with ALBI grade 1 and NRI ≥ 97.5 (95%CI: 56.445-523.839), indicating a significant additive interaction between the ALBI score and NRI in PHLF.
CONCLUSION
Both the ALBI score and NRI were risk factors for PHLF, and there was an additive interaction between the ALBI score and NRI in PHLF.
Core Tip: This study investigated the relationship between the albumin-bilirubin (ALBI) score and nutritional risk index (NRI) in post-hepatectomy liver failure (PHLF). Of the 186 patients who underwent hepatectomy for hepatocellular carcinoma and were included in the study, 44 (23.66%) developed PHLF. Both the ALBI score and NRI were risk factors for PHLF, and there was an additive interaction between the ALBI score and NRI in PHLF. Patients with either of these risk factors should receive preventive pharmacological treatment and help with nutrition to reduce the risk of PHLF.
