Pu et al reported a nomogram for predicting outcomes following surgery for recurrent hepatolithiasis. This can help to identify a patient who may require more aggressive management. The authors are from Anhui Medical University, University of Science and Technology of China, Benghu Medical College, and affiliated hospitals.
Patient selection: recurrent hepatolithiasis after biliary surgery
Outcome: obvious bile duct-related symptoms requiring symptoms, strictures requiring surgical intervention, disease-related cancer, death
Parameters:
(1) bilateral hepatolithiasis
(2) number of previous biliary operations (OR relative to 1)
(3) immediate clearance of stones
(4) neutrophil to lymphocyte ratio (NLR)
(5) albumin to globulin ratio (AGR)
|
Parameter
|
Finding
|
Points
|
|
bilateral hepatolithiasis
|
no
|
0
|
|
|
yes
|
38.3
|
|
previous operations
|
no
|
0
|
|
|
2
|
21.6
|
|
|
3
|
87
|
|
|
>= 4
|
100
|
|
immediate clearance
|
no
|
50
|
|
|
yes
|
0
|
|
NLR
|
< 2.462
|
0
|
|
|
>= 2.462
|
37
|
|
AGR
|
> 1.5
|
0
|
|
|
<= 1.5
|
38.3
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 263.6
value of X =
= (0.01749 * (score)) - 2.239
probability of poor outcome =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.75.
