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A novel online calculator based on noninvasive markers (ALBI and APRI) for predicting post-hepatectomy liver failure in patients with hepatocellular carcinoma

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机构: [1]The Cancer Center, the First Hospital of Jilin University, Changchun, China [2]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military MedicalUniversity (Naval Medical University), Shanghai, China [3]Department of Clinical Medicine, Second Military Medical University (Naval Medical University), Shanghai,China [4]Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, United States [5]Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Yunnan, China [6]Department of General Surgery, Liuyang People’s Hospital, Hunan, China [7]The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China [8]Department of General Surgery, Ziyang First People’s Hospital, Sichuan, China [9]Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., HongKong SAR, China
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关键词: Hepatocellular carcinoma

摘要:
Post-hepatectomy liver failure (PHLF) remains the primary cause of in-hospital mortality after hepatectomy. Identifying predictors of PHLF is important to improve surgical safety. We sought to identify the predictive accuracy of two noninvasive markers, albumin-bilirubin (ALBI) and aspartate aminotransferase to platelet count ratio index (APRI), to predict PHLF among patients with hepatocellular carcinoma (HCC), and to build up an online prediction calculator.Patients who underwent resection for HCC between 2013 and 2016 at 6 Chinese hospitals were retrospectively analyzed. The independent predictors of PHLF were identified using univariate and multivariate analyses; derivative data were used to construct preoperative and postoperative nomogram models. Receiver operating characteristic (ROC) curves for the two predictive models, and ALBI, APRI, Child-Pugh, model for end-stage liver disease (MELD) scores were compared relative to predictive accuracy for PHLF.Among the 767 patients in the analytic cohort, 102 (13.3%) experienced PHLF. Multivariable logistic regression analysis identified high ALBI grade (>-2.6) and high APRI grade (>1.5) as independent risk factors associated with PHLF in both the preoperative and postoperative models. Two nomogram predictive models and corresponding web-based calculators were subsequently constructed. The areas under the ROC curves for the postoperative and preoperative models, APRI, ALBI, MELD and Child-Pugh scores in predicting PHLF were 0.844, 0.789, 0.626, 0.609, 0.569, and 0.560, respectively.ALBI and APRI demonstrated more accurate ability to predict PHLF than Child-Pugh and MELD. Two online calculators that combined ALBI and APRI were proposed as useful preoperative and postoperative tools for individually predicting the occurrence of PHLF among patients with HCC.Copyright © 2020 Elsevier Masson SAS. All rights reserved.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 4 区 胃肠肝病学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 胃肠肝病学
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第一作者机构: [1]The Cancer Center, the First Hospital of Jilin University, Changchun, China
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通讯机构: [1]The Cancer Center, the First Hospital of Jilin University, Changchun, China [2]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military MedicalUniversity (Naval Medical University), Shanghai, China [*1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University(Navy Medical University), No. 225, Changhai Road, Shanghai 200438, China [*2]The Cancer Center, the First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, China
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