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An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery.

Ismail Labgaa1, Luis Cano2, Orsalia Mangana3

  • 1Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Rue du Bugnon 46, CH-1011, Lausanne, Switzerland. ismail.labgaa@chuv.ch.

Perioperative Medicine (London, England)
|November 10, 2022
PubMed
Summary
This summary is machine-generated.

Perioperative decrease of albumin (ΔAlb) predicts complications after liver surgery. A novel algorithm using ΔAlb improves prediction accuracy for patient outcomes.

Keywords:
BiomarkersDecision-makingLiver resectionMorbidityPartial hepatectomyPredictors

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Clinical Prediction Models

Background:

  • Perioperative decrease in albumin (ΔAlb) is a potential complication predictor in digestive surgery.
  • Its utility in liver surgery remains under investigation.

Purpose of the Study:

  • To evaluate the predictive value of ΔAlb for complications following liver surgery.
  • To develop and assess a predictive algorithm based on ΔAlb.

Main Methods:

  • Bicentric retrospective analysis of 110 liver surgery patients (2010-2016).
  • ΔAlb calculated as the difference between preoperative and postoperative albumin on postoperative day 0.
  • Development of a multiparametric algorithm incorporating ΔAlb to predict overall complications (Clavien classification).

Main Results:

  • 60% of patients experienced complications.
  • Higher ΔAlb (15.8 g/L) was observed in patients with complications versus those without (9.5 g/L) (p<0.001).
  • ΔAlb demonstrated predictive value (AUC 0.75); the algorithm improved prediction (AUC 0.84, p=0.03). ΔAlb was an independent predictor (HR 1.12, p=0.002).

Conclusions:

  • ΔAlb is a promising independent predictor of complications after liver surgery.
  • A novel decision-tree algorithm based on ΔAlb can anticipate postoperative complications.