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Background: Hepatectomy is a complex procedure with high morbidity and mortality.
Early prediction/prevention of major complications is highly valuable for patient care.
Surgical APGAR score (SAS) has been validated to predict post-surgical complications (PCs).
Goal: We aimed to define a simple complications classification following hepatectomy based on a therapy-oriented severity Clavien-Dindo classification (CDC).
Methods: 119 patients undergoing liver resection were included. PCs were determined at follow-up based on CDC. Clinicopathological factors were used to calculate SAS. A receiver-operator characteristic (ROC) curve analysis estimated the predictive value of SAS for PCs. Circulating markers levels of liver injury were analyzed as critical elements on PCs.
Results: SAS (P=0.008), estimated blood-loss (P=0.018) and operation time (P=0.0008) were associated with PCs. SAS was reduced in patients with (+) compared to those without (-) complications (6.64±1.84 vs 5.70±1.79, P=0.0079). The area-under-the-curve was 0.646 by ROC, indicating an acceptable discrimination with 65% possibility to distinguish (-) and (+) groups (P=0.004).
Best cutoff value for SAS was ≤6/≥7, at which sensitivity and specificity were maximal.
ALT/ASL levels were significantly different within the group with 9-10 SAS points (P=0.01 and 0.02).
Conclusion: SAS provides accurate risk stratification for major PCs after hepatectomy, and might help improving the overall patient outcome.
Czech Phycological Society is a scientific organization that is dedicated to the development of phycology in the area of the Czech Republic and Central Europe, and the distribution of phycological information. The Society organizes the Annual Meetings and Conferences and publishes the Bulletin Czech Phycology.
Daniele mulipondo lyavantumi
(2010)
Daudi namu Goliashi
(2010)
Davidi na Goliya
(2010)