Abstract: Objective To develop and validate a risk nomogram model for predicting acute liver function deterioration (ALFD) after interventional surgery for hepatocellular carcinoma (HCC). Methods Ninety patients with HCC who underwent interventional surgery at the hospital from May 2020 to May 2022 were selected Patients were divided into a deterioration group (n=29 cases) and a non-deterioration group (n=61 cases) based on the occurrence of ALFD post-surgery. Clinical data from both groups were collected. Univariate and multivariate logistic regression analyses were used to identify risk factors for ALFD after intervention, and the risk prediction model was established and verified. Results Univariate and multivariate logistic regression analyses showed that Child-Pugh grade B and high levels of fibrosis-4 index (FIB-4) and aspartate aminotransferase to platelet ratio (APRI) were risk factors for ALFD in patients with HCC after intervention (P<0.05). The nomogram model showed that Child-Pugh grade B was the strongest predictor, followed by high levels of FIB and APRI. Model validation showed that the area under the ROC curve of the column graph was 0.751 (95%CI: 0.665~0.840), and the C-index was 0.811. The Hosmer-Lemeshow goodness of fit test showed no significant difference between predicted and observed value (χ²=4.001, P=0.463), indicating that the model had accurate predictive capability and good discriminatory power. Conclusion Child-Pugh grade B, high levels of FIB and APRI are risk factors for ALFD in patients with HCC post-intervention. The nomogram model effectively predicts the risk of ALFD after interventional surgery for HCC.

Key words: Hepatocellular carcinoma, interventional surgery, Acute liver deterioration, Risk factors, Risk nomogram model