Chinese Hepatolgy ›› 2022, Vol. 27 ›› Issue (4): 426-430.

• Liver Failure • Previous Articles     Next Articles

Predictive value and influence factors of APRI with 5-HT levels on post hepatectomy liver failure

RU Guo-dong1, ZHANG Chun-xuan1, WANG Chui-fang1, SONG Lai-gao1, RU Qi2*   

  1. 1. Department of General Surgery, Liaocheng Tumor Hospital, Shangdong 252000, China;
    2. Department of Ultrasonography, Qilu Hospital, Shandong University, Qingdao 250063, China
  • Received:2021-09-09 Online:2022-04-30 Published:2022-06-02

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Abstract: Objective To investigate the influencing factors and the predictive value of aspartate aminotransferase/platelet ratio index (APRI) and 5-hydroxytryptamine (5-HT) levels on post hepatectomy liver failure (PHLF).Methods The clinical data of 105 patients who underwent hepatectomy from February 2017 to March 2020 were retrospectively analyzed. According to occurrence of PHLF, they were divided into group A (liver failure, n=21) and group B (no liver failure, n=84). The influencing factors on liver failure were analyzed. The area under the curve (AUC), sensitivity and specificity of APRI and 5-HT in predicting PHLF were evaluated.Results Among 105 subjects, 21 cases (20.00%) developed PHLF: Grade A 14 (66.67%), Grade B 5 (23.81%), Grade C 2 cases (9.52%) according to the classification of liver failure. Among 21 PHLF patients, 1 patient died (4.76%) during 6 months of following up. Univariate analysis showed that there was no significant difference between 2 groups in gender, weight, hypertension, diabetes, preoperative ALT, preoperative AST, tumor number, and obstructive time of portal vein (P>0.05); There were significant differences of age, tumor diameter, preoperative prothrombin time (PT), preoperative albumin, preoperative Child-Pugh classification, operation time, blood loss, and liver resection range between the 2 groups (P<0.05). Binary logistic regression analysis showed that age, tumor diameter ≥ 10 cm, preoperative PT, preoperative albumin, preoperative Child-Pugh classification as C/B, operation time, blood loss > 1000ml and large-scale hepatectomy were risk factors of PHLF. The preoperative APRI and 5-HT of group A were higher than those of group B (P<0.05). Receiver operator characteristic curve (ROC) analysis showed that the AUC of APRI and 5-HT in predicting PHLF were 0.996 and 0.853 respectively (P<0.05); the sensitivity was 100.00% and 81.00%; the specificity was 95.20% and 84.50%.Conclusion Age, tumor diameter, preoperative PT, preoperative albumin, preoperative Child-Pugh classification, operative time, blood loss and liver resection range are risk factors of PHLF. APRI and 5-HT can be used for preoperative prediction which can provide references on predicting the occurrence of liver failure.

Key words: Hepatectomy, Liver failure, Aspartate aminotransferase/platelet ratio index, 5-hydroxytryptamine