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• W3044303906 abstract "Presenter: Patrick Starlinger MD | Mayo Clinic, Rochester Background: Preoperative risk assessment for postoperative liver dysfunction (LD) still poses a major challenge in patients undergoing liver resection. Currently, only limited options are available to easily assess liver function prior to surgery. Aspartate Aminotransferase/Platelet Ratio Index (APRI) and Albumin-Bilirubin Grade (ALBI) are validated markers in patients suffering from hepatic pathologies. Previously, both markers have been implicated as a valid predictor for postoperative LD after liver resection. We were recently able to demonstrate a highly significant and clinically relevant predictive value of the combination of the APRI and ALBI score to predict postoperative outcome after liver resection. Within this analysis, we aimed to validate our exploratory findings in a larger cohort and subsequently develop a web based application system to facilitate easy clinical translation. Methods: Assessing the National Surgical Quality Improvement Program (NSQIP) database, we identified 13401 patients undergoing liver resection from 2014 to 2017 for preoperative blood values and detailed 30-day postoperative outcomes. Preoperative APRI+ALBI score was calculated from these routine laboratory tests. Association of APRI+ALBI with postoperative LD as well as morbidity and mortality was assessed via univariate analyses. Results: The combination of both scores (APRI+ALBI) significantly differed between groups (LD: median -3.92; No LD: median -4.18, P=0.002) and was further found to be superior over each score alone. This association was particular significant if patients undergoing major liver resection. Further, APRI+ALBI gradually decreased with postoperative LD grade (No LD: median -4.03, grade A LD -3.96, grade B LD: -3.52, grade C LD: -3.47 (P < 0.001). In line with these Resultshigher preoperative APRI+ALBI levels were also observed in patients suffering from postoperative morbidity (P < 0.001), and mortality (P=0.001). Detailed Results are illustrated in Table 1. We further developed a web based application to calculate the APRI+ALBI score to define the specific risk of postoperative LD morbidity and mortality of each individual score result. Conclusion: We were able to validate our recent exploratory findings, confirming that the combination of APRI and ALBI is vital to predict postoperative outcome after liver resection with highest accuracy. Further we developed a web based application to allow clinical translation of these findings and facilitate quick and easy risk assessment prior to liver resection using routine laboratory parameters." @default.
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• W3044303906 date "2020-01-01" @default.
• W3044303906 modified "2023-09-27" @default.
• W3044303906 title "Preoperative Apri+Albi Score Allows Risk Stratification Prior To Liver Resection" @default.
• W3044303906 doi "https://doi.org/10.1016/j.hpb.2020.04.816" @default.
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