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Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study

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机构: [1]First Hosp Jilin Univ, Gen Surg Ctr, Dept Hepatobiliary & Pancreat Surg, Changchun, Jilin, Peoples R China [2]Second Mil Med Univ, Naval Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, Shanghai, Peoples R China [3]Tsinghua Univ, Beijing Tsinghua Changgung Hosp, Hepatopancreatobiliary Ctr, Beijing, Peoples R China [4]Harbin Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Harbin, Heilongjiang, Peoples R China [5]Nantong Univ, Affiliated Hosp, Dept Hepatobiliary Surg, Nantong, Jiangsu, Peoples R China [6]Shandong Univ, Shandong Prov Hosp, Dept Hepatobiliary Surg, Jinan, Shandong, Peoples R China [7]Shandong First Med Univ, Affiliated Hosp 1, Dept Gen Surg, Jinan, Peoples R China [8]Shandong Prov Qianfoshan Hosp, Jinan, Shandong, Peoples R China [9]Liuyang Peoples Hosp, Dept Gen Surg, Liuyang, Hunan, Peoples R China [10]Fuyang Peoples Hosp, Dept Hepatobiliary Surg, Fuyang, Anhui, Peoples R China [11]Ziyang First Peoples Hosp, Dept Gen Surg, Ziyang, Sichuan, Peoples R China [12]Zhejiang Univ, Huzhou Hosp, Huzhou Cent Hosp, Dept Hepatobiliary Surg, Huzhou, Zhejiang, Peoples R China [13]Fourth Hosp Harbin, Dept Gen Surg 1, Harbin, Heilongjiang, Peoples R China [14]Puer Peoples Hosp, Dept Hepatobiliary Surg, Puer, Yunnan, Peoples R China [15]Second Peoples Hosp Changzhi, Dept Gen Surg 2, Changzhi, Peoples R China [16]Ohio State Univ, Wexner Med Ctr, Dept Surg, Columbus, OH USA [17]Chinese Univ Hong Kong, Fac Med, Shatin, Hong Kong, Peoples R China
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关键词: Hepatectomy Hepatocellular carcinoma Textbook outcome Risk prediction Complications

摘要:
Background and aims: The concept of textbook outcomes (TOs) has gained increased attention as a critical metric to assess the quality and success of outcomes following complex surgery. A simple yet effective scoring system was developed and validated to predict risk of not achieving textbook outcomes (non-TOs) following hepatectomy for hepatocellular carcinoma (HCC). Methods: Using a multicenter prospectively collected database, risk factors associated with non -TO among patients who underwent hepatectomy for HCC were identified. A predictive scoring system based on factors identified from multivariate regression analysis was used to risk stratify patients relative to non -TO. The score was developed using 70 % of the overall cohort and validated in the remaining 30 %. Results: Among 3681 patients, 1458 (39.6 %) failied to experience a TO. Based on the derivation cohort, obesity, American Society of Anaesthesiologists score(ASA score), Child -Pugh grade, tumor size, and extent of hepatectomy were identified as independent predictors of non -TO. The scoring system ranged from 0 to 10 points. Patients were categorized into low (0-3 points), intermediate (4-6 points), and high risk (7-10 points) of nonTO. In the validation cohort, the predicted risk of developing non-TOs was 39.0 %, which closely matched the observed risk of 39.9 %. There were no differences among the predicted and observed risks within the different risk categories. Conclusions: A novel scoring system was able to predict risk of non -TO accurately following hepatectomy for HCC. The score may enable early identification of individuals at risk of adverse outcomes and inform surgical decision-making, and quality improvement initiatives.

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大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 外科
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出版当年[2023]版:
Q1 SURGERY Q2 ONCOLOGY
最新[2023]版:
Q1 SURGERY Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]First Hosp Jilin Univ, Gen Surg Ctr, Dept Hepatobiliary & Pancreat Surg, Changchun, Jilin, Peoples R China
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通讯机构: [1]First Hosp Jilin Univ, Gen Surg Ctr, Dept Hepatobiliary & Pancreat Surg, Changchun, Jilin, Peoples R China [2]Second Mil Med Univ, Naval Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, Shanghai, Peoples R China
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