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BMC Surgery

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Open Access 01-12-2024 | Research

Abnormal coagulation after hepatectomy in patients with normal preoperative coagulation function

Authors: Liting Kuang, Weibin Lin, Dahui Wang, Bin Chen

Published in: BMC Surgery | Issue 1/2024

Abstract

Background

To explore the risk factors for postoperative abnormal coagulation (PAC) and establish a predictive model for patients with normal preoperative coagulation function who underwent hepatectomy.

Materials and Methods

A total of 661 patients with normal preoperative coagulation function who underwent hepatectomy between January 2015 and December 2021 at the First Affiliated Hospital of Sun Yat-sen University were divided into two groups: the postoperative abnormal coagulation group (PAC group, n = 362) and the normal coagulation group (non-PAC group, n = 299). Univariate and multivariate logistic analyses were used to identify the risk factors for PAC.

Results

The incidence of PAC in 661 patients who underwent hepatectomy was 54.8% (362/661). The least absolute shrinkage and selection operator (LASSO) method was used for multivariate logistic regression analysis. The preoperative international normalized ratio (INR), intraoperative succinyl gelatin infusion and major hepatectomy were found to be independent risk factors for PAC. A nomogram for predicting the PAC after hepatectomy was constructed. The model presented a receiver operating characteristic (ROC) curve of 0.742 (95% confidence interval (CI): 0.697–0.786) in the training cohort. The validation set demonstrated a promising ROC of 0.711 (95% CI: 0.639–0.783), and the calibration curve closely approximated the true incidence. Decision curve analysis (DCA) was performed to assess the clinical usefulness of the predictive model. The risk of PAC increased when the preoperative international normalized ratio (INR) was greater than 1.025 and the volume of intraoperative succinyl gelatin infusion was greater than 1500 ml.

Conclusion

The PAC is closely related to the preoperative INR, intraoperative succinyl gelatin infusion and major hepatectomy. A three-factor prediction model was successfully established for predicting the PAC after hepatectomy.

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Title: Abnormal coagulation after hepatectomy in patients with normal preoperative coagulation function
Authors: Liting Kuang
Weibin Lin
Dahui Wang
Bin Chen
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2024
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-024-02406-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abnormal coagulation after hepatectomy in patients with normal preoperative coagulation function

Abstract

Background

Materials and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusion

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