jengstrand

Comparing the accuracy of prediction models to detect clinically relevant post-hepatectomy liver failure early after major hepatectomy ➡️ doi.org/10.1093/bjs/znad433 Arterial lactate measurements were recently suggested as an early predictor of clinically relevant post-hepatectomy liver failure (PHLF), but in the subgroup of major liver resections a more comprehensive approach is needed. 1⃣In a cohort of 649 major hepatectomy patients, lactate on postoperative day (POD) 1 (AUC 0.75) was outperformed by both clinical risk factors (AUC 0.81, P < 0.05) and bilirubin POD1 (AUC 0.83, P < 0.05) in predicting clinically relevant PHLF grade B/C as defined by the International Study Group of Liver Surgery (ISGLS). 2⃣A multivariable logistic regression model including five clinical risk factors and bilirubin POD1 (AUC 0.87 (P < 0.01)) was developed to predict PHLF grade B/C in major hepatectomy already on POD1, with an equally good discriminatory potential for 90-day mortality as the established ISGLS criteria. Great work by Ruth Baumgartner, Jennie Engstrand, Patric Rajala, Jonathan Grip, Poya Ghorbani, Ernesto Sparrelid, Stefan Gilg #SoMe4Surgery #MedTwitter #SurgEd #Surgery #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @P_C_E_ @dice_europe @BJSAcademy @young_bjs