Orozco et al reported factors associated with post-hepatectomy liver failure (PHLF) and mortality for a non-cirrhotic patient. These can help to identify a patient who may require more aggressive management. The authors are from the University of Kentucky.
Patient selection: non-cirrhotic patient undergoing partial hepatectomy.
Rate of post-hepatectomy liver failure (PHLF): 4.7%
Rate of 30-day mortality: 1.4% overall; 11.5% with PHLF
Predictors of liver failure:
(1) extent of liver resection (trisectionectomy OR 3.7; right total lobectomy OR 4.2)
(2) metastatic tumors to liver (OR 1.8)
(3) transfusions (OR 2.0)
(4) organ/space surgical site infection (OR 2.8)
(5) postoperative pneumonia (OR 2.4)
(6) sepsis (OR 2.3) or septic shock (OR 5.7)
Predictors of 30-day mortality:
(1) post-hepatectomy renal failure (OR 8.5)
(2) older age (OR 1.04 per year)
(3) male sex (OR 1.8)
(4) sepsis (OR 3.0) or septic shock (OR 3.9)
(5) post-hepatectomy liver failure
