BACKGROUND: An early prediction of poor outcomes is essential in the management of patients after a liver resection. The aim of this study was to evaluate the role of selected biochemical parameters on post-operative day 1 (POD 1) in the prediction of morbidity and mortality after a liver resection for colorectal metastases. METHOD: This retrospective study was based on 236 major liver resections for colorectal metastases performed between 2006 and 2011. Results of biochemical tests of blood samples obtained on POD 1 were assessed as predictors of primary outcome measures (hepatic and overall morbidity, 90-day mortality) using multiple regression and receiver-operating characteristics (ROC). RESULTS: Hepatic morbidity, overall morbidity and 90-day mortality rates were 18.6%, 28.0% and 4.7%, respectively. On the basis of multiple regression analysis and comparisons of the prediction models, serum bilirubin was selected for the prediction of hepatic (>2.05 mg/dl, sensitivity 69.2%, specificity 71.2%) and overall (>2.05 mg/dl, sensitivity 61.1% and specificity 71.2%) morbidity, and aspartate aminotransferase (AST) was selected for the prediction of 90-day mortality (>798 U/l, sensitivity 62.5% and specificity 90.4%). DISCUSSION: Biochemical analyses of blood on POD1 enables stratification of patients into low- and high-risk groups for negative outcomes, with serum bilirubin associated with overall and hepatic morbidity and AST associated with mortality.
BACKGROUND: An early prediction of poor outcomes is essential in the management of patients after a liver resection. The aim of this study was to evaluate the role of selected biochemical parameters on post-operative day 1 (POD 1) in the prediction of morbidity and mortality after a liver resection for colorectal metastases. METHOD: This retrospective study was based on 236 major liver resections for colorectal metastases performed between 2006 and 2011. Results of biochemical tests of blood samples obtained on POD 1 were assessed as predictors of primary outcome measures (hepatic and overall morbidity, 90-day mortality) using multiple regression and receiver-operating characteristics (ROC). RESULTS: Hepatic morbidity, overall morbidity and 90-day mortality rates were 18.6%, 28.0% and 4.7%, respectively. On the basis of multiple regression analysis and comparisons of the prediction models, serum bilirubin was selected for the prediction of hepatic (>2.05 mg/dl, sensitivity 69.2%, specificity 71.2%) and overall (>2.05 mg/dl, sensitivity 61.1% and specificity 71.2%) morbidity, and aspartate aminotransferase (AST) was selected for the prediction of 90-day mortality (>798 U/l, sensitivity 62.5% and specificity 90.4%). DISCUSSION: Biochemical analyses of blood on POD1 enables stratification of patients into low- and high-risk groups for negative outcomes, with serum bilirubin associated with overall and hepatic morbidity and AST associated with mortality.
Authors: D Tamandl; B Gruenberger; B Herberger; S Schoppmann; M Bodingbauer; M Schindl; H Puhalla; E Fleischmann; W Schima; R Jakesz; F Laengle; T Gruenberger Journal: Eur J Surg Oncol Date: 2006-10-12 Impact factor: 4.424
Authors: Nuh N Rahbari; O James Garden; Robert Padbury; Mark Brooke-Smith; Michael Crawford; Rene Adam; Moritz Koch; Masatoshi Makuuchi; Ronald P Dematteo; Christopher Christophi; Simon Banting; Val Usatoff; Masato Nagino; Guy Maddern; Thomas J Hugh; Jean-Nicolas Vauthey; Paul Greig; Myrddin Rees; Yukihiro Yokoyama; Sheung Tat Fan; Yuji Nimura; Joan Figueras; Lorenzo Capussotti; Markus W Büchler; Jürgen Weitz Journal: Surgery Date: 2011-01-14 Impact factor: 3.982
Authors: Thomas A Aloia; Bridget N Fahy; Craig P Fischer; Stephen L Jones; Andrea Duchini; Joseph Galati; A Osama Gaber; R Mark Ghobrial; Barbara L Bass Journal: HPB (Oxford) Date: 2009-09 Impact factor: 3.647
Authors: Yoji Kishi; Eddie K Abdalla; Yun Shin Chun; Daria Zorzi; David C Madoff; Michael J Wallace; Steven A Curley; Jean-Nicolas Vauthey Journal: Ann Surg Date: 2009-10 Impact factor: 12.969
Authors: Pim B Olthof; Joost Huiskens; Niek R Schulte; Dennis A Wicherts; Marc G Besselink; Olivier R Busch; Michal Heger; Thomas M van Gulik Journal: HPB (Oxford) Date: 2016-09-02 Impact factor: 3.647
Authors: Kewei Li; Fanwen Jiang; Matthew Aizpuru; Ellen L Larson; Xiaolong Xie; Rongxing Zhou; Bo Xiang Journal: Medicine (Baltimore) Date: 2021-02-12 Impact factor: 1.817