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01-02-2017 | 2016 SSAT Poster Presentation

Albumin-Bilirubin Score: Predicting Short-Term Outcomes Including Bile Leak and Post-hepatectomy Liver Failure Following Hepatic Resection

Authors: Nikolaos Andreatos, Neda Amini, Faiz Gani, Georgios A. Margonis, Kazunari Sasaki, Vanessa M. Thompson, David J. Bentrem, Bruce L. Hall, Henry A. Pitt, Ana Wilson, Timothy M. Pawlik

Published in: Journal of Gastrointestinal Surgery | Issue 2/2017

Abstract

Introduction

Post-operative bile leak (BL) and post hepatectomy liver failure (PHLF) are the major potential sources of morbidity among patients undergoing liver resection. We sought to define the incidence of BL and PHLF among a large cohort of patients, as well as examine the prognostic impact of model for end-stage liver disease (MELD) and albumin-bilirubin (ALBI) scores to predict these short-term outcomes.

Materials and Methods

Patients who underwent a hepatectomy between January 1, 2014 and December 31, 2014 were identified using the National Surgical Quality Improvement Program (NSQIP) liver-targeted database. Risk factors for BL and PHLF were identified using multivariable logistic regression.

Results

Among the 3064 patients identified, median age was 60 years (IQR 50–68). Most patients underwent surgery (78.9 %) for malignant lesions. Post-operatively, 250 (8.5 %) patients experienced a BL while PHLF occurred in 149 cases (4.9 %). Both MELD (MELD <10 4.9 %; MELD ≥10, 10 %; P = 0.001) and ALBI (grade 1, 4.0 %; grade 2, 7.2 %; grade 3, 10.0 %; P = 0.001) were associated with PHLF occurrence, while only ALBI predicted PHLF severity (P = 0.008). Moreover, ALBI was associated with BL (grade 1, 7.1 %; grade 2, 11.5 %; grade 3, 14.0 %; P < 0.001), whereas MELD was not (MELD <10, 8.4 %; MELD ≥10, 11.2 %; P = 0.13). On multivariable analysis, ALBI grade 2/3 was associated with PHLF (OR 1.57, 95 % CI 1.08–2.27; P = 0.02), PHLF severity (OR 3.06, 95 % CI 1.50–6.23; P = 0.003), and the development of a BL (OR 1.35, 95 % CI 1.02–1.80; P = 0.04).

Conclusion

The ALBI score was associated with short-term post-operative outcomes following hepatic resection and represents a useful pre-operative risk-assessment tool to identify patients at risk for adverse post-operative outcomes.

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Title: Albumin-Bilirubin Score: Predicting Short-Term Outcomes Including Bile Leak and Post-hepatectomy Liver Failure Following Hepatic Resection
Authors: Nikolaos Andreatos
Neda Amini
Faiz Gani
Georgios A. Margonis
Kazunari Sasaki
Vanessa M. Thompson
David J. Bentrem
Bruce L. Hall
Henry A. Pitt
Ana Wilson
Timothy M. Pawlik
Publication date: 01-02-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-016-3246-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Albumin-Bilirubin Score: Predicting Short-Term Outcomes Including Bile Leak and Post-hepatectomy Liver Failure Following Hepatic Resection

Abstract

Introduction

Materials and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusion

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