A nomogram for prediction of posthepatectomy liver failure in patients with hepatocellular carcinoma: A retrospective study

To generate a nomogram to predict posthepatectomy liver failure (PHLF), we attempted to elucidate salient risk factors in patients with hepatocellular carcinoma (HCC).We performed a retrospective review of 665 patients with HCC who received hepatectomy in 2 academic institutions in China. Independen...

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Bibliographic Details
Published in:Medicine (Baltimore) 2019-12, Vol.98 (51), p.e18490-e18490
Main Authors: Shen, Yi-Nan, Tang, Tian-Yu, Yao, Wei-Yun, Guo, Cheng-Xiang, Yi-Zong, Song, Wei, Liang, Ting-Bo, Bai, Xue-Li
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - surgery
China - epidemiology
Female
Hepatectomy - adverse effects
Humans
Liver Failure - epidemiology
Liver Failure - etiology
Liver Neoplasms - surgery
Male
Middle Aged
Nomograms
Observational Study
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Retrospective Studies
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Summary:To generate a nomogram to predict posthepatectomy liver failure (PHLF), we attempted to elucidate salient risk factors in patients with hepatocellular carcinoma (HCC).We performed a retrospective review of 665 patients with HCC who received hepatectomy in 2 academic institutions in China. Independent risk factors for PHLF were identified from putative demographic, intrinsic, biochemical, surgery-related, and volumetric data. A predictive nomogram was formulated based on relevant risk factors, and we compared this with existing models.We identified clinical signs of portal hypertension (P = .023), serum total bilirubin (P = .001), serum creatinine (P = .039), and intraoperative hemorrhage (P = .015) as being important risk factors in predicting PHLF. The nomogram had a C-index of 0.906 for the externally validated data. The nomogram displayed better predictive value than 2 of the other most cited models (C-indices of 0.641 and 0.616, respectively) in the current cohort. Additionally, we were able to patients into low- (
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000018490