Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Authors

Omid Ghamarnejad, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Elias Khajeh, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Nahid Rezaei, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Khashayar Afshari, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Ali Adelian, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Mohammadsadegh Nikdad, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Katrin Hoffmann, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany.
Arianeb Mehrabi, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, 69120, Germany. Arianeb.Mehrabi@med.uni-heidelberg.de.

Document Type

Article

Publication Title

Scientific reports

Abstract

The aim of this study was to assess and compare the discriminatory performance of well-known risk assessment scores in predicting mortality risk after extended hepatectomy (EH). A series of 250 patients who underwent EH (≥5 segments resection) were evaluated. Aspartate aminotransferase-to-platelet ratio index (APRI), albumin to bilirubin (ALBI) grade, predictive score developed by Breitenstein et al., liver fibrosis (FIB-4) index, and Heidelberg reference lines charting were used to compute cut-off values, and the sensitivity and specificity of each risk assessment score for predicting mortality were also calculated. Major morbidity and 90-day mortality after EH increased with increasing risk scores. APRI (86%), ALBI (86%), Heidelberg score (81%), and FIB-4 index (79%) had the highest sensitivity for 90-day mortality. However, only the FIB-4 index and Heidelberg score had an acceptable specificity (70% and 65%, respectively). A two-stage risk assessment strategy (Heidelberg-FIB-4 model) with a sensitivity of 70% and a specificity 86% for 90-day mortality was proposed. There is no single specific risk assessment score for patients who undergo EH. A two-stage screening strategy using Heidelberg score and FIB-4 index was proposed to predict mortality after major liver resection.

First Page

930

DOI

10.1038/s41598-020-57748-7

Publication Date

1-22-2020

Recommended Citation

Ghamarnejad, Omid; Khajeh, Elias; Rezaei, Nahid; Afshari, Khashayar; Adelian, Ali; Nikdad, Mohammadsadegh; Hoffmann, Katrin; and Mehrabi, Arianeb, "Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy" (2020). Internal Medicine. 311.
https://scholar.bridgeporthospital.org/internal_medicine/311

Identifier

31969586 (pubmed); PMC6976620 (pmc); 10.1038/s41598-020-57748-7 (doi); 10.1038/s41598-020-57748-7 (pii)