Detailed Abstract
[Liver Oral Presentation 2 - Liver (Liver Disease/Surgery)]
[LV OP 2-S6] Failure to Achieve Textbook Outcomes: Stratifying Risk among Patients Undergoing Hepatectomy for Hepatocellular Carcinoma
Han LIU 1, Feng WEI 1, Yong-Kang DIAO 1, Si-Yuan WANG 1, Ying-Jian LIANG 1, Yi-Fan WU 1, Qi-Xuan ZHENG 1, Xian-Ming WANG 1, Guo-Yue LV 1, Tian YANG 1
1 Hepatobiliary And Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, CHINA, 2 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA, 3 Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, CHINA, 4 Hepatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, CHINA, 5 Hepatobiliary Surgery, Affiliated Hospital of Nantong University, CHINA, 6 Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, CHINA, 7 General Surgery, First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, CHINA
Background : The concept of textbook outcomes (TOs) has gained increased attention as a critical metric to assess the quality and success of outcomes following complex surgery. A simple yet effective scoring system was developed and validated to predict risk of not achieving textbook outcomes (non-TOs) following hepatectomy for hepatocellular carcinoma (HCC).
Methods : Using a multicenter prospectively collected database, risk factors associated with non-TO among patients who underwent hepatectomy for HCC were identified. A predictive scoring system based on factors identified from multivariate regression analysis was used to risk stratify patients relative to non-TO. The score was developed using 70% of the overall cohort and validated in the remaining 30%.
Results : Among 3 681 patients, 1 458 (39.6%) failied to experience a TO. Based on the derivation cohort, obesity, American Society of Anaesthesiologists score(ASA score), Child-Pugh grade, tumor size, and extent of hepatectomy were identified as independent predictors of non-TO. The scoring system ranged from 0 to 10 points. Patients were categorized into low (0-3 points), intermediate (4-6 points), and high risk (7-10 points) of non-TO. In the validation cohort, the predicted risk of developing non-TOs was 39.0%, which closely matched the observed risk of 39.9%. There were no differences among the predicted and observed risks within the different risk categories.
Conclusions : A novel scoring system was able to predict risk of non-TO accurately following hepatectomy for HCC. The score may enable early identification of individuals at risk of adverse outcomes and inform surgical decision-making, and quality improvement initiatives.
Methods : Using a multicenter prospectively collected database, risk factors associated with non-TO among patients who underwent hepatectomy for HCC were identified. A predictive scoring system based on factors identified from multivariate regression analysis was used to risk stratify patients relative to non-TO. The score was developed using 70% of the overall cohort and validated in the remaining 30%.
Results : Among 3 681 patients, 1 458 (39.6%) failied to experience a TO. Based on the derivation cohort, obesity, American Society of Anaesthesiologists score(ASA score), Child-Pugh grade, tumor size, and extent of hepatectomy were identified as independent predictors of non-TO. The scoring system ranged from 0 to 10 points. Patients were categorized into low (0-3 points), intermediate (4-6 points), and high risk (7-10 points) of non-TO. In the validation cohort, the predicted risk of developing non-TOs was 39.0%, which closely matched the observed risk of 39.9%. There were no differences among the predicted and observed risks within the different risk categories.
Conclusions : A novel scoring system was able to predict risk of non-TO accurately following hepatectomy for HCC. The score may enable early identification of individuals at risk of adverse outcomes and inform surgical decision-making, and quality improvement initiatives.
SESSION
Liver Oral Presentation 2
Room F 3/22/2024 4:30 PM - 5:30 PM