Predicting post-hepatectomy liver failure using a nomogram based on portal vein width, inflammatory indices, and the albumin-bilirubin score

doi:10.4240/wjgs.v17.i2.99529

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Feb 27, 2025; 17(2): 99529
Published online Feb 27, 2025. doi: 10.4240/wjgs.v17.i2.99529

Table 1 Baseline data of the enrolled patients

Characteristics	Total (n = 248)	Training (n = 164)	Validation (n = 84)	P value
Gender, (male vs female)	204/44	139/25	65/19	0.150
Body weight, kg	65.00 (60.00, 71.00)	64.50 (60.00, 70.00)	66.00 (60.00, 73.50)	0.344
Hypertension, (yes, no)	48/199	34/129	14/70	0.430
Diabetes mellitus, (yes, no)	28/219	21/142	7/77	0.285
PT, second	11.80 (11.28, 12.70)	11.95 (11.30, 12.80)	11.80 (11.20, 12.40)	0.111
INR	1.04 (0.98, 1.11)	1.04 (0.97, 1.10)	1.06 (1.01, 1.11)	0.063
ALT, U/L	36.00 (24.75, 51.25)	37.00 (24.00, 51.25)	35.00 (26.00, 49.25)	0.798
ALB, g/L	41.06 ± 4.07	41.32 ± 4.06	40.55 ± 4.04	0.158
TBil, μmol/L	15.68 (12.21, 20.30)	15.52 (12.50, 20.64)	15.85 (11.80, 19.22)	0.885
DBil, μmol/L	5.12 (3.47, 7.04)	4.37 (3.13, 6.06)	6.44 (5.43, 8.33)	< 0.001
GGT, U/L	49.00 (30.00, 77.00)	46.50 (29.00, 75.25)	50.00 (33.25, 77.25)	0.41
ALP, U/L	83.00 (67.75, 111.00)	86.00 (70.00, 109.00)	78.50 (64.00, 114.25)	0.369
Cr, μmol/L	62.00 (54.77, 71.12)	61.60 (54.65, 71.62)	63.05 (54.98, 69.47)	0.95
PLT, 10⁹/L	126.00 (86.75, 171.00)	125.00 (82.50, 168.25)	128.50 (96.50, 175.50)	0.171
Lymphocyte, 10⁹/L	1.28 (0.94, 1.63)	1.23 (0.86, 1.61)	1.32 (1.08, 1.64)	0.046
Monocyte, 10⁹/L	0.39 (0.28, 0.47)	0.36 (0.27, 0.45)	0.42 (0.30, 0.52)	0.008
Neutrophil, 10⁹/L	2.78 (2.09, 3.55)	2.65 (2.01, 3.48)	2.96 (2.20, 3.95)	0.132
NLR	2.21 (1.62, 3.19)	2.24 (1.68, 3.20)	2.15 (1.51, 3.00)	0.427
PLR	101.95 (75.32, 134.54)	102.65 (78.24, 136.89)	98.40 (72.94, 125.26)	0.344
PVD, mm	15.00 (14.00, 16.05)	15.00 (13.30, 17.00)	15.00 (14.00, 16.00)	0.337
Number of tumors, ≥ 2/1	26/222	15/149	11/73	0.337
ALBI score	-2.70 ± 0.34	-2.72 ± 0.34	-2.65 ± 0.34	0.119
APRI score	0.68 (0.48, 1.30)	0.76 (0.49, 1.30)	0.62 (0.44, 1.20)	0.161
MELD score	56.87 ± 3.14	56.78 ± 2.82	57.05 ± 3.70	0.519
PALBI score	-2.61 (-2.74, -2.44)	-2.61 (-2.75, -2.48)	-2.58 (-2.73, -2.41)	0.144
PHLF, no/yes	161/87	109/55	52/32	0.476

PT: Prothrombin time; INR: International normalized ratio; ALT: Alanine transaminase; ALB: Albumin; TBil: Total bilirubin; DBil: Direct bilirubin; GGT: Gamma-glutamyl transferase; ALP: Alkaline phosphatase; Cr: Creatinine; PLT: Platelet count; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; PVD: Portal vein width; ALBI: Albumin-bilirubin; APRI: Aspartate aminotransferase-platelet ratio index; MELD: Model for end-stage liver disease; PALBI: Platelet-albumin-bilirubin; PHLF: Post hepatectomy liver failure.

Table 2 Univariate and multivariate analyses of post hepatectomy liver failure factors

Characteristics	Univariable logistic regression		Multivariable logistic regression
Characteristics	OR (95%CI)	P value	OR (95%CI)	P value
Gender, (male vs female)	1.137 (0.467, 2.769)	0.777
Body weight, kg	0.984 (0.955, 1.013)	0.262
Hypertension, (yes, no)	0.780 (0.356, 1.707)	0.534
Diabetes mellitus, (yes, no)	0.804 (0.312, 2.074)	0.652
PT, second	2.432 (1.696, 3.487)	0.000	1.346 (0.545, 3.325)	0.520
INR	4461.289 (122.808, 162067.386)	0.000	20.021 (0.003, 115173.617)	0.497
ALT, U/L	1.009 (0.994, 1.025)	0.258
ALB, g/L	0.840 (0.767, 0.921)	0.000	-	-
TBil, μmol/L	1.088 (1.036, 1.142)	0.001	-	-
DBil, μmol/L	1.064 (0.957, 1.183)	0.252
GGT, U/L	1.005 (0.999, 1.011)	0.086
ALP, U/L	1.005 (0.999, 1.011)	0.087
Cr, μmol/L	0.978 (0.951, 1.005)	0.107
PLT, 10⁹/L	0.990 (0.983, 0.996)	0.001	1.004 (0.995, 1.013)	0.346
Lymphocyte, 10⁹/L	0.211 (0.102, 0.438)	0.000	-	-
Monocyte, 10⁹/L	0.197 (0.022, 1.764)	0.146
Neutrophil, 10⁹/L	0.884 (0.696, 1.124)	0.314
NLR	1.354 (1.086, 1.689)	0.007	1.495 (1.126, 1.984)	0.005
PLR	1.002 (0.997, 1.008)	0.379
PVD, mm	1.587 (1.320, 1.907)	0.000	1.603 (1.288, 1.994)	0.000
Number of tumors, ≥ 2/1	0.543 (0.186, 1.585)	0.264
ALBI score	18.305 (5.682, 58.965)	0.000	8.868 (2.144, 36.678)	0.003

"-" indicates an indicator that should be excluded by covariance; PT: Prothrombin time; INR: International normalized ratio; ALT: Alanine transaminase; ALB: Albumin; TBil: Total bilirubin; DBil: Direct bilirubin; GGT: Gamma-glutamyl transferase; ALP: Alkaline phosphatase; Cr: Creatinine; PLT: Platelet count; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; PVD: Portal vein width; ALBI: Albumin-bilirubin.

Citation: Sun K, Li JB, Chen YF, Zhai ZJ, Chen L, Dong R. Predicting post-hepatectomy liver failure using a nomogram based on portal vein width, inflammatory indices, and the albumin-bilirubin score. World J Gastrointest Surg 2025; 17(2): 99529
URL: https://www.wjgnet.com/1948-9366/full/v17/i2/99529.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i2.99529