Hepatectomy Prognosis Score - Medical Algorithm

Description

Yamanaka et al used a scoring system to grade the severity of postoperative hepatic dysfunction following hepatectomy. The authors are from Hyogo College of Medicine in Japan.

Patient selection: partial hepatectomy for hepatocellular carcinoma

Risk factors for postoperative hepatic failure:

(1) too much removed

(2) too little reserve

Parameters:

(1) stage of hepatic encephalopathy

(2) ascites

(3) hyperammonemia based on blood ammonia

(4) hyperbilirubinemia based on serum total bilirubin

Parameter	Finding	Points
grade of encephalopathy	none	0
	stage I or II	20
	stage III or IV	40
ascites	absent	0
	present	10
serum ammonia	< 130 µg/dL (normal)	0
	130 to 180 µg/dL	10
	> 180 µg/dL (>=1.4 times ULN)	20
serum total bilirubin	< 1.2 mg/dL (normal)	0
	1.2 to 6.0 mg/dL	0
	> 6 mg/dL	10 * ((value) – 6)

where:

• Point assignment appears simplistic, using simple multiples.

total score =

= SUM(points for all 4 parameters)

Postoperative mortality was also scored:

Parameter	Finding	Points
postoperative mortality	none	0
	<= 30 days after surgery (1 month)	100
	> 30 days after surgery	80

Interpretation:

• minimum total score: 0

• maximum total score for survivor: uncertain, may be capped at 60

• maximum total score: 100

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Description

Specialty

Objective

ICD-10

Score of Yamanaka et al for Severity of Postoperative Hepatic Dysfunction Following Partial Hepatectomy

Purpose: To determine the severity of postoperative hepatic dysfunction following hepatectomy using the score of Yamanaka et al.

Description

Specialty

Objective

ICD-10