Risk Factors of Melendez et al for Perioperative Mortality in Patients Undergoing Extended Hepatic Resection

Description

Extended hepatic resection is a major surgical procedure that may be associated with significant perioperative mortality. Identification of specific risk factors can identify patients at high risk for mortality. The authors are from Memorial Sloan-Kettering Cancer Center and the University of Ferrara (Italy).

Extended hepatic resections = resection of 4 or more hepatic segments:

(1) right extended hepatectomy: segments IV to VIII

(2) left extended hepatectomy: segments II-V and VIII

Indications for an extended hepatic resection:

(1) large primary hepatic tumors

(2) metatastic tumors to the liver

Risk Factor	Finding	Points
cholangitis	absent	0
	present	1
serum creatinine	<= 1.3 mg/dL	0
	> 1.3 mg/dL	1
total bilirubin	<= 6.0 mg/dL	0
	> 6.0 mg/dL	1
blood loss during surgery	<= 3 liters	0
	> 3 liters	1
vena caval resection	not performed	0
	performed	1

number of risk factors =

= SUM(points for all 5 risk factors)

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 5

• Perioperative mortality increases as the number of risk factors increases.

• The presence of 2 or 3 of the 3 preoperatively known variables can be used to better advise the patient and family of the high operative risks.

Number of Risk Factors	Mortality
0	3%
1	10%
>= 2	100%

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Description

Specialty

ICD-10