Development and Validation of a Prediction Score for Complications after Hepatectomy in Hepatitis B-Related Hepatocellular Carcinoma Patients

Abstract

Objective and BackgroundThe aim of the present study was to develop and validate a prediction score for postoperative complications by severity and guide perioperative management and patient selection in hepatitis B-related hepatocellular carcinoma patients undergoing liver resection.MethodsA total of 1543 consecutive liver resections cases were included in the study. Randomly selected sample set of 70% of the study cohort was used to develop a score to predict complications III–V and the remaining 30% was used to validate the score. Based on the preoperative and predictable intraoperative parameters, logistic regression analysis was used to identify risk factors and create an integer score for the predicting of complication.ResultsAmerican Society of Anesthesiologists category, portal hypertension, major liver resection (more than 3 segments) and extrahepatic procedures were identified as independent predictors for complications III–V by logistic regression analysis. A score system integrating these 4 factors was stratified into three groups and significantly predicted the risk of complications III–V, with a rate of 1.6%, 11.9% and 65.6% for low, moderate and high risk, respectively. Using the score, the complications risk could be predicted accurately in the validation set, without significant differences between predicted (10.4%) and observed (8.4%) risks for complications III–V (P = 0.466).ConclusionsBased on four preoperative risk factors, we have developed and validated an integer-based risk score to predict postoperative severe complications after liver resection for hepatitis B-related hepatocellular carcinoma patients in high-volume surgical center. This score may contribute to preoperative risk stratification and clinical decision-making.

Minor hepatectomy for hepatocellular carcinoma in a patient with portal hypertension: A case report and review of the literature

“…[28] As infectious and high-grade complications were significantly associated with long-term outcome and cancer-specific mortality, [26] controllable factors were crucial in preventing such adverse events. Intraoperatively, major hepatectomy (more than three segments) or prolonged operation time was identified as independent factors for major complications, [26,29,30] and postoperative nutritional support and broad-spectrum anti-infectious treatment may serve as an effective strategy for improving long-term survival. [31,32] In our case, there was repeated purulent drainage and severe infection, but with attentive care, the patient surmounted the postoperative clinical course.…”

Upgraded nomograms for the prediction of complications and survival in patients with colorectal liver metastases treated with neoadjuvant chemotherapy followed by hepatic resection

“…Previous findings indicated high serum GGT levels to be significantly related to the occurrence of postoperative major complications in CRLM patients who did not receive NAC (13), and our study further demonstrates their positive relationship with postoperative complications in CRLM patients undergoing NAC followed by hepatic resection. Overall, the extent of hepatectomy (minor liver resection or major liver resection) and intraoperative blood loss are important factors associated with trauma caused by surgery in patients (17,18). As major liver resection and greater intraoperative blood loss cause serious trauma, these factors have a positive relationship with and are predictive of the occurrence of postoperative complications.…”

Developing a Rapid and Sensitive Colorimetric Sensor for Detection of Food Adulterant Rhodamine‐B in Real Samples

“…Yueru Chen et al mentioned the constituents present in Broussonetia species, [35] among which vitexin, [38] apigenin [39] etc. flavonoids, Dihydrosyringin [40] etc. Penylpropanoids and Broussoside D [40] etc polyphenols are noteworthy.…”

“…flavonoids, Dihydrosyringin [40] etc. Penylpropanoids and Broussoside D [40] etc polyphenols are noteworthy. In Figure S1, the chromatograms of BZ-EXT were analyzed, and the retention time, area, height, and area % are shown.…”