An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery
Abstract Background Perioperative decrease of albumin (ΔAlb) appeared as a promising predictor of complications after digestive surgery, but its role after liver surgery remains unclear. This study aimed to analyze whether and how ΔAlb can be used to predict complications after liver surgery. Method...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Perioperative Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13741-022-00285-w |
| _version_ | 1811225116271443968 |
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| author | Ismail Labgaa Luis Cano Orsalia Mangana Gaëtan-Romain Joliat Emmanuel Melloul Nermin Halkic Markus Schäfer Eric Vibert Nicolas Demartines Nicolas Golse Martin Hübner |
| author_facet | Ismail Labgaa Luis Cano Orsalia Mangana Gaëtan-Romain Joliat Emmanuel Melloul Nermin Halkic Markus Schäfer Eric Vibert Nicolas Demartines Nicolas Golse Martin Hübner |
| author_sort | Ismail Labgaa |
| collection | DOAJ |
| description | Abstract Background Perioperative decrease of albumin (ΔAlb) appeared as a promising predictor of complications after digestive surgery, but its role after liver surgery remains unclear. This study aimed to analyze whether and how ΔAlb can be used to predict complications after liver surgery. Methods A bicentric retrospective analysis of patients undergoing liver surgery (2010–2016) was performed, following TRIPOD guidelines. The preoperative and postoperative difference of albumin was calculated on POD 0 and defined as ΔAlb. Patients with any missing variable were excluded. The primary endpoint was overall complications according to the Clavien classification. A multiparametric algorithm based on ΔAlb was generated to optimize prediction performance. Results A total of 110 patients were analyzed. At least one complication occurred in 66 (60%) patients. Patients with and without complication showed a ΔAlb of 15.8 vs. 9.5 g/L (p<0.001). Area under ROC curve (AUC) of ΔAlb was 0.75 (p<0.01.). The ΔAlb-based algorithm showed an AUC of 0.84 (p<0.01), significantly improving performance (p=0.03). Multivariable analysis identified ΔAlb as independent predictor of complications (HR, 1.12; 95% CI, 1.01–1.07; p = 0.002). Conclusions ΔAlb appeared as a promising predictor independently associated with the risk of complication after liver surgery. The study presents a novel decision-tree based on ΔAlb to anticipate complications. |
| first_indexed | 2024-04-12T09:00:32Z |
| format | Article |
| id | doaj.art-452507bc7d284dd683afe5b29c7f4948 |
| institution | Directory Open Access Journal |
| issn | 2047-0525 |
| language | English |
| last_indexed | 2024-04-12T09:00:32Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj.art-452507bc7d284dd683afe5b29c7f49482022-12-22T03:39:15ZengBMCPerioperative Medicine2047-05252022-11-011111810.1186/s13741-022-00285-wAn algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgeryIsmail Labgaa0Luis Cano1Orsalia Mangana2Gaëtan-Romain Joliat3Emmanuel Melloul4Nermin Halkic5Markus Schäfer6Eric Vibert7Nicolas Demartines8Nicolas Golse9Martin Hübner10Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Nutrition Metabolism and Cancer, INSERM, University of Rennes, INRAE, CHU Pontchaillou, UMR 1241 NUMECANDepartment of Hepatobiliary Surgery, Paul-Brousse Hospital, Assistance Publique Hôpitaux de ParisDepartment of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Department of Hepatobiliary Surgery, Paul-Brousse Hospital, Assistance Publique Hôpitaux de ParisDepartment of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Department of Hepatobiliary Surgery, Paul-Brousse Hospital, Assistance Publique Hôpitaux de ParisDepartment of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL)Abstract Background Perioperative decrease of albumin (ΔAlb) appeared as a promising predictor of complications after digestive surgery, but its role after liver surgery remains unclear. This study aimed to analyze whether and how ΔAlb can be used to predict complications after liver surgery. Methods A bicentric retrospective analysis of patients undergoing liver surgery (2010–2016) was performed, following TRIPOD guidelines. The preoperative and postoperative difference of albumin was calculated on POD 0 and defined as ΔAlb. Patients with any missing variable were excluded. The primary endpoint was overall complications according to the Clavien classification. A multiparametric algorithm based on ΔAlb was generated to optimize prediction performance. Results A total of 110 patients were analyzed. At least one complication occurred in 66 (60%) patients. Patients with and without complication showed a ΔAlb of 15.8 vs. 9.5 g/L (p<0.001). Area under ROC curve (AUC) of ΔAlb was 0.75 (p<0.01.). The ΔAlb-based algorithm showed an AUC of 0.84 (p<0.01), significantly improving performance (p=0.03). Multivariable analysis identified ΔAlb as independent predictor of complications (HR, 1.12; 95% CI, 1.01–1.07; p = 0.002). Conclusions ΔAlb appeared as a promising predictor independently associated with the risk of complication after liver surgery. The study presents a novel decision-tree based on ΔAlb to anticipate complications.https://doi.org/10.1186/s13741-022-00285-wPartial hepatectomyLiver resectionDecision-makingMorbidityBiomarkersPredictors |
| spellingShingle | Ismail Labgaa Luis Cano Orsalia Mangana Gaëtan-Romain Joliat Emmanuel Melloul Nermin Halkic Markus Schäfer Eric Vibert Nicolas Demartines Nicolas Golse Martin Hübner An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery Perioperative Medicine Partial hepatectomy Liver resection Decision-making Morbidity Biomarkers Predictors |
| title | An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery |
| title_full | An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery |
| title_fullStr | An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery |
| title_full_unstemmed | An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery |
| title_short | An algorithm based on the postoperative decrease of albumin (ΔAlb) to anticipate complications after liver surgery |
| title_sort | algorithm based on the postoperative decrease of albumin δalb to anticipate complications after liver surgery |
| topic | Partial hepatectomy Liver resection Decision-making Morbidity Biomarkers Predictors |
| url | https://doi.org/10.1186/s13741-022-00285-w |
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