Using the Comprehensive Complication Index to Rethink the ISGLS Criteria for Post-hepatectomy Liver Failure in an International Cohort of Major Hepatectomies
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: To compare different criteria for post-hepatectomy liver failure (PHLF) and evaluate the association between International Study Group of Liver Surgery (ISGLS) PHLF and the Comprehensive Complication Index (CCI)" and 90-day mortality.
SUMMARY OF BACKGROUND DATA: PHLF is a serious complication following hepatic resection. Multiple criteria have been developed to characterize PHLF.
METHODS: Adults who underwent major hepatectomies at twelve international centers (2010-2020) were included. We identified patients who met criteria for PHLF based on three definitions: 1) ISGLS, 2) Balzan (INR > 1.7 and bilirubin > 2.92mg/dL) or 3) Mullen (peak bilirubin >7mg/dL). We compared the 90-day mortality and major morbidity predicted by each definition. We then used logistic regression to determine the odds of CCI>40 and 90-day mortality associated with ISGLS grades.
RESULTS: Among 1646 included patients, 19 (1.1%) met Balzan, 68 (4.1%) met Mullen, and 444 (27.0%) met ISGLS criteria for PHLF. Of the three definitions, the ISGLS criteria best predicted 90-day mortality (AUC = 0.72; sensitivity 69.4%). Patients with ISGLS grades B&C were at increased odds of CCI > 40 (grade B OR 4.0; 95% CI: 2.2-7.2; grade C OR 137.0; 95% CI: 59.2-317.4). Patients with ISGLS grade C were at increased odds of 90-day mortality (OR 113.6; 95% CI: 55.6-232.1). Grade A was not associated with CCI> 40 or 90-day mortality.
CONCLUSIONS: In this diverse international cohort of major hepatectomies, ISGLS grade A was not associated with 90-day mortality or high CCI, calling into question the current classification of patients in this group as having clinically significant PHLF.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:277 |
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| Enthalten in: |
Annals of surgery - 277(2023), 3 vom: 01. März, Seite e592-e596 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Calthorpe, Lucia [VerfasserIn] |
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| Anmerkungen: |
Date Completed 08.02.2023 Date Revised 02.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/SLA.0000000000005338 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM334501180 |
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| 100 | 1 | |a Calthorpe, Lucia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Using the Comprehensive Complication Index to Rethink the ISGLS Criteria for Post-hepatectomy Liver Failure in an International Cohort of Major Hepatectomies |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 08.02.2023 | ||
| 500 | |a Date Revised 02.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To compare different criteria for post-hepatectomy liver failure (PHLF) and evaluate the association between International Study Group of Liver Surgery (ISGLS) PHLF and the Comprehensive Complication Index (CCI)" and 90-day mortality | ||
| 520 | |a SUMMARY OF BACKGROUND DATA: PHLF is a serious complication following hepatic resection. Multiple criteria have been developed to characterize PHLF | ||
| 520 | |a METHODS: Adults who underwent major hepatectomies at twelve international centers (2010-2020) were included. We identified patients who met criteria for PHLF based on three definitions: 1) ISGLS, 2) Balzan (INR > 1.7 and bilirubin > 2.92mg/dL) or 3) Mullen (peak bilirubin >7mg/dL). We compared the 90-day mortality and major morbidity predicted by each definition. We then used logistic regression to determine the odds of CCI>40 and 90-day mortality associated with ISGLS grades | ||
| 520 | |a RESULTS: Among 1646 included patients, 19 (1.1%) met Balzan, 68 (4.1%) met Mullen, and 444 (27.0%) met ISGLS criteria for PHLF. Of the three definitions, the ISGLS criteria best predicted 90-day mortality (AUC = 0.72; sensitivity 69.4%). Patients with ISGLS grades B&C were at increased odds of CCI > 40 (grade B OR 4.0; 95% CI: 2.2-7.2; grade C OR 137.0; 95% CI: 59.2-317.4). Patients with ISGLS grade C were at increased odds of 90-day mortality (OR 113.6; 95% CI: 55.6-232.1). Grade A was not associated with CCI> 40 or 90-day mortality | ||
| 520 | |a CONCLUSIONS: In this diverse international cohort of major hepatectomies, ISGLS grade A was not associated with 90-day mortality or high CCI, calling into question the current classification of patients in this group as having clinically significant PHLF | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Cacciaguerra, Andrea Benedetti |e verfasserin |4 aut | |
| 700 | 1 | |a Conroy, Patricia C |e verfasserin |4 aut | |
| 700 | 1 | |a Hibi, Taizo |e verfasserin |4 aut | |
| 700 | 1 | |a Hilal, Mohammad Abu |e verfasserin |4 aut | |
| 700 | 1 | |a Hoffman, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Keon Min |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jaeyun |e verfasserin |4 aut | |
| 700 | 1 | |a Adam, Mohamed Abdelgadir |e verfasserin |4 aut | |
| 700 | 1 | |a Alseidi, Adnan |e verfasserin |4 aut | |
| 700 | 0 | |a International Post-Hepatectomy Liver Failure Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Abe, Yuta |e investigator |4 oth | |
| 700 | 1 | |a Armstrong, Thomas |e investigator |4 oth | |
| 700 | 1 | |a Ferrero, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Corvera, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Hayashi, Koki |e investigator |4 oth | |
| 700 | 1 | |a Imamura, Taisuke |e investigator |4 oth | |
| 700 | 1 | |a Kitago, Minoru |e investigator |4 oth | |
| 700 | 1 | |a Kubo, Shoji |e investigator |4 oth | |
| 700 | 1 | |a Ishii, Masatsugu |e investigator |4 oth | |
| 700 | 1 | |a Mocchegiani, Federico |e investigator |4 oth | |
| 700 | 1 | |a Morise, Zenichi |e investigator |4 oth | |
| 700 | 1 | |a Ogawa, Kosuke |e investigator |4 oth | |
| 700 | 1 | |a Okamura, Yukiyasu |e investigator |4 oth | |
| 700 | 1 | |a Otsuka, Shimpei |e investigator |4 oth | |
| 700 | 1 | |a Primrose, John |e investigator |4 oth | |
| 700 | 1 | |a Rosso, Edoardo |e investigator |4 oth | |
| 700 | 1 | |a Rotellar, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Russolillo, Nadia |e investigator |4 oth | |
| 700 | 1 | |a Syed, Shareef M |e investigator |4 oth | |
| 700 | 1 | |a Tanabe, Minoru |e investigator |4 oth | |
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| 700 | 1 | |a Zimmitti, Giuseppe |e investigator |4 oth | |
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