Comparative Analysis of the Discriminatory Performance of Different Well-Known Risk Assessment Scores for Extended Hepatectomy

Sci Rep. 2020 Jan 22;10(1):930. doi: 10.1038/s41598-020-57748-7.

Abstract

The aim of this study was to assess and compare the discriminatory performance of well-known risk assessment scores in predicting mortality risk after extended hepatectomy (EH). A series of 250 patients who underwent EH (≥5 segments resection) were evaluated. Aspartate aminotransferase-to-platelet ratio index (APRI), albumin to bilirubin (ALBI) grade, predictive score developed by Breitenstein et al., liver fibrosis (FIB-4) index, and Heidelberg reference lines charting were used to compute cut-off values, and the sensitivity and specificity of each risk assessment score for predicting mortality were also calculated. Major morbidity and 90-day mortality after EH increased with increasing risk scores. APRI (86%), ALBI (86%), Heidelberg score (81%), and FIB-4 index (79%) had the highest sensitivity for 90-day mortality. However, only the FIB-4 index and Heidelberg score had an acceptable specificity (70% and 65%, respectively). A two-stage risk assessment strategy (Heidelberg-FIB-4 model) with a sensitivity of 70% and a specificity 86% for 90-day mortality was proposed. There is no single specific risk assessment score for patients who undergo EH. A two-stage screening strategy using Heidelberg score and FIB-4 index was proposed to predict mortality after major liver resection.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Albumins
  • Aspartate Aminotransferases
  • Bilirubin
  • Female
  • Hepatectomy / methods*
  • Hepatectomy / mortality*
  • Humans
  • Liver Cirrhosis
  • Male
  • Middle Aged
  • Platelet Count
  • Predictive Value of Tests
  • Research Design*
  • Risk
  • Risk Assessment / methods*
  • Sensitivity and Specificity

Substances

  • Albumins
  • Aspartate Aminotransferases
  • Bilirubin