Shen et al reported a nomogram for predicting posthepatectomy liver failure (PHLF) for a patient with hepatocellular carcinoma. This can help to identify a patient who may require more aggressive management. The authors are Zhejiang Universtiy, the People's Hospital of Changxing Country and the Second Military Medical University in Shanghai.
Patient selection: status post hepatectomy for hepatocellular carcinoma
Parameters:
(1) serum total bilirubin in µmol/L, from 0 to 65
(2) serum creatinine in µmol/L, from 20 to 140
(3) intraoperative hemorrhage in mL, from 0 to 5,000
(4) clinical signs of portal hypertension (CSPH)
points for serum total bilirubin =
= 1.53846 * (bilirubin)
points for serum creatinine =
= (0.494167 * (creatinine)) - 9.88333
points for intraoperative hemorrhage =
= 0.00572 * (blood loss)
|
CSPH
|
Points
|
|
no
|
0
|
|
yes
|
22.9
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 210.8
value of X =
= (0.0684 * (score)) - 6.349
probability of posthepatectomy liver failure =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.82 in the derivation and 0.91 in the validation cohorts.
