Preoperative Score of Breitenstein et al for Predicting Complications After Liver Resection in a Patient Without Cirrhosis

Description

Breitenstein et al reported a preoperative score for predicting the risk of complications after liver resection in a patient without cirrhosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University Hospital Zurich.

Patient selection: liver resection, noncirrhosis, ASA 1 to 4

Outcome: Clavien-Dindo Grade III to V complications

Parameters:

(1) ASA grade

(2) serum AST concentration in U/L

(3) extent of liver resection

(4) extrahepatic procedure (hepaticojejunostomy, bowel resection)

Parameter	Finding	Points
ASA grade	1 or 2	0
	3 or 4	1
serum AST	< 40 U/L	0
	>= 40 U/L	3
extent of liver resection	< 3 Couinaud liver segments (minor)	0
	>= 3 Couinaud liver segments (major)	2
extrahepatic procedure	no	0
	yes	4

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 10

• The higher the score the greater the risk for complications.

Score	Risk Group	Percent High Grade Complications
0 to 2	low	16%
3 to 5	intermediate	37%
6 to 10	high	60%

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Preoperative Score of Breitenstein et al for Predicting Complications After Liver Resection in a Patient Without Cirrhosis

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