Combining E-PASS model and disease specific risk factors to predict severe morbidity after liver and bile duct resection for perihilar cholangiocarcinoma
| Autor: | I. Kazakov, O. V. Melekhina, A. Koroleva, Mikhail Efanov, Y. Kulezneva, E. Zamanov, A. Vankovich, Ruslan Alikhanov, Victor Tsvirkun |
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| Rok vydání: | 2021 |
| Předmět: |
Disease specific
medicine.medical_specialty Multivariate analysis Surgical stress 030230 surgery Cholangiocarcinoma 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors medicine Hepatectomy Humans Radical surgery Retrospective Studies Framingham Risk Score Hepatology Bile duct business.industry Gastroenterology Perioperative medicine.anatomical_structure Bile Duct Neoplasms Liver 030220 oncology & carcinogenesis Bile Ducts Radiology Morbidity Complication business Klatskin Tumor |
| Zdroj: | HPB. 23:387-393 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2020.07.009 |
| Popis: | Estimation of physiologic ability and surgical stress system (E-PASS) has been shown to be effective in predicting morbidity after surgery for perihilar cholangiocarcinoma (PHCC). Nevertheless, E-PASS does not include an assessment of the disease specific risk factors. The aim of the study was to estimate the combined impact of E-PASS and specific preoperative factors on major morbidity for PHCC patients.A retrospective analysis of a prospectively collected data was performed. Severe morbidity according to complication comprehensive index was defined as ≥40 points. A value of comprehensive risk score (CRS) ≥1 was taken as critical.Multivariate analysis of perioperative data from 122 patients revealed significant impact of five factors (CRS ≥1, future liver remnant volume50%, T4 stage, moderate and severe cholangitis, INR) on the risk of severe morbidity after resection. The AUC for the combination of these factors was classified as good predictive value (0.810, 95% CI 0.729-0.891) and poor predictive value (0.673, 95% CI 0.573-0.773) for CRS alone (p = 0.040).A combination of E-PASS with disease specific risk factors is a reliable predictive model for major morbidity for patients undergoing radical surgery for PHCC. |
| Databáze: | OpenAIRE |
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