Comparative analysis of the discriminatory performance of different well-known risk assessment scores for extended hepatectomy

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 r...

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Hauptverfasser: Ghamarnejad, Omid (VerfasserIn) , Khajeh, Elias (VerfasserIn) , Rezaei, Nahid (VerfasserIn) , Afshari, Khashayar (VerfasserIn) , Adelian, Ali (VerfasserIn) , Nikdad, Mohammadsadegh (VerfasserIn) , Hoffmann, Katrin (VerfasserIn) , Mehrabi, Arianeb (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 22 January 2020
In: Scientific reports
Year: 2020, Jahrgang: 10
ISSN:2045-2322
DOI:10.1038/s41598-020-57748-7
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41598-020-57748-7
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41598-020-57748-7
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Verfasserangaben:Omid Ghamarnejad, Elias Khajeh, Nahid Rezaei, Khashayar Afshari, Ali Adelian, Mohammadsadegh Nikdad, Katrin Hoffmann & Arianeb Mehrabi

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520 |a 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. 
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