Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study
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.
基金:
National Natural Science Foundation of China [81972726, 82273074, 82241223, U20A20360]; Dawn Project Foundation of Shanghai [21SG36]; Shanghai Health and Hygiene Discipline Leader Project [2022XD001]; Shanghai Outstanding Academic Leader Program [23XD1424900]
第一作者机构:[1]First Hosp Jilin Univ, Gen Surg Ctr, Dept Hepatobiliary & Pancreat Surg, Changchun, Jilin, Peoples R China
通讯作者:
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
推荐引用方式(GB/T 7714):
Liu Han,Diao Yong-Kang,Wei Feng,et al.Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study[J].EJSO.2024,50(9):doi:10.1016/j.ejso.2024.108477.
APA:
Liu, Han,Diao, Yong-Kang,Wei, Feng,Wang, Si-Yuan,Liang, Ying-Jian...&Yang, Tian.(2024).Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study.EJSO,50,(9)
MLA:
Liu, Han,et al."Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study".EJSO 50..9(2024)