Construction of a predictive model for acute liver failure after hepatectomy based on neutrophil-to-lymphocyte ratio and albuminbilirubin score

作     者：Xiao-Pei Li Zeng-Tao Bao Li Wang Chun-Yan Zhang Wen Yang 

作者机构：Department of Family Planning and Assisted Reproductive TechnologyThe First People’s Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina Department of Gastrointestinal SurgeryThe First People’s Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina Department of Laboratory MedicineThe First People’s Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina Department of GynecologyThe First People’s Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2024年第16卷第4期

页      面：1087-1096页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：reviewed and approved by the Ethics Committee of the First People’s Hospital of Lianyungang No.LW-20231120001-01 

主　　题：Acute liver failure Hepatocellular carcinoma Hepatectomy Neutrophil-to-lymphocyte ratio Albumin-bilirubin score 

摘      要：BACKGROUND Acute liver failure(ALF)is a common cause of postoperative death in patients with hepatocellular carcinoma(HCC)and is a serious threat to patient *** neutrophil-to-lymphocyte ratio(NLR)is a common inflammatory indicator that is associated with the prognosis of various diseases,and the albumin-bilirubin score(ALBI)is used to evaluate liver function in liver cancer ***,this study aimed to construct a predictive model for postoperative ALF in HCC tumor integrity resection(R0)based on the NLR and ALBI,providing a basis for clinicians to choose appropriate treatment *** To construct an ALF prediction model after R0 surgery for HCC based on NLR and *** In total,194 patients with HCC who visited The First People’s Hospital of Lianyungang to receive R0 between May 2018 and May 2023 were enrolled and divided into the ALF and non-ALF *** compared differences in the NLR and ALBI between the two *** risk factors of ALF after R0 surgery for HCC were screened in the univariate *** risk factors were analyzed by multifactorial logistic *** then constructed a prediction model of ALF after R0 surgery for HCC.A receiver operating characteristic curve,calibration curve,and decision curve analysis(DCA)were used to evaluate the value of the prediction *** Among 194 patients with HCC who met the standard inclusion criteria,46 cases of ALF occurred after R0(23.71%).There were significant differences in the NLR and ALBI between the two groups(P0.05).The univariate analysis showed that alpha-fetoprotein(AFP)and blood loss volume(BLV)were significantly higher in the ALF group compared with the non-ALF group(P0.05).The multifactorial analysis showed that NLR,ALBI,AFP,and BLV were independent risk factors for ALF after R0 surgery in *** predictive efficacy of NLR,ALBI,AFP,and BLV in predicting the occurrence of ALT after R0 surgery for HCC was average[area under the curve(AUC)NLR=0.767,AUCALB