Oussoultzoglou et al identified risk factors associated with mortality in patients undergoing a major hepatectomy. These can help to identify a patient who may benefit from a delay in surgery until after correction of underlying metabolic problems. The authors are from Hopitaux Universitaires de Strasbourg in France.
Patient selection: without cirrhosis, often with cancer involving the liver
Operation: resection of at least 4 contiguous liver segments
Outcome: in-hospital mortality
Parameters:
(1) preoperative serum ALT
(2) preoperative prothrombin ratio
(3) preoperative indocyanine green retention rate at 15 minutes in percent
(4) preoperative biliary drainage
(5) resection of extrahepatic bile ducts
|
Parameter |
Finding |
Points |
|
preoperative serum ALT |
<= 40 U/L |
0 |
|
|
> 40 U/L |
1 |
|
preoperative prothrombin ratio |
>= 70% |
0 |
|
|
< 70% |
1 |
|
indocyanine green retention |
<= 15% |
0 |
|
|
> 15% |
1 |
|
biliary drainage |
no |
0 |
|
|
yes |
1 |
|
resection of extrahepatic bile ducts |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of in-hospital mortality.
|
Total Score |
In-Hospital Mortality |
|
0 |
0% |
|
1 |
3% |
|
2 to 5 |
67% |
Specialty: Gastroenterology, Surgery, general, Surgery, orthopedic
ICD-10: ,
