College of Basic Medical Sciences, Third Military Medical University (Army Medical University), Chongqing, China.
Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Sichuan, China.
BMC Gastroenterol. 2021 May 22;21(1):233. doi: 10.1186/s12876-021-01818-1.
As a nutritional index, preoperative serum prealbumin highly correlates with surgical complications. However, the correlation between preoperative prealbumin and postoperative complications remains unclear in liver transplantation (LT).
A total of 191 patients who underwent LT between 2015 and 2019 were included in the retrospective analysis. According to a cut-off value calculated from a receiver operating characteristic (ROC) curve, the patients were divided into normal and low preoperative prealbumin groups. Univariable and multivariable logistic regression analyses were used to identify independent risk factors for postoperative complications. In addition, patients were divided into subgroups by Model for End-stage Liver Disease (MELD) score, and the association between preoperative prealbumin and postoperative complications was also assessed in each group.
A total of 111 (58.1%) patients were included in the low prealbumin group based on a cut-off value of 120 mg/L. The area under the ROC curve (AUC) was 0.754 (95% confidence interval [CI] 0.678-0.832). Low prealbumin (95% CI 1.51-12.8, P = 0.007) was identified as a predictor for postoperative complications based on multivariable regression. In the low and normal prealbumin groups, the prevalence rates of postoperative complications were 27.5% and 8.0% (P = 0.003) in the MELD score ≤ 15 subgroup and 53.3% and 20.0% (P = 0.197) in the MELD score > 15 subgroup, respectively.
Preoperative prealbumin was associated with postoperative complications in LT, and preoperative nutritional support benefitted postoperative recovery, especially for patients with low MELD scores.
作为一种营养指标，术前血清前白蛋白与手术并发症高度相关。然而，在肝移植（LT）中，术前前白蛋白与术后并发症之间的相关性尚不清楚。
回顾性分析了 2015 年至 2019 年间接受 LT 的 191 例患者。根据受试者工作特征（ROC）曲线计算的截断值，将患者分为正常和低术前前白蛋白组。采用单变量和多变量逻辑回归分析确定术后并发症的独立危险因素。此外，根据终末期肝病模型（MELD）评分将患者分为亚组，并评估每组术前前白蛋白与术后并发症的关系。
根据 120mg/L 的截断值，共有 111 例（58.1%）患者被纳入低前白蛋白组。ROC 曲线下面积（AUC）为 0.754（95%置信区间 [CI] 0.678-0.832）。多变量回归显示，低前白蛋白（95%CI 1.51-12.8，P=0.007）是术后并发症的预测因素。在 MELD 评分≤15 的亚组中，低和正常前白蛋白组的术后并发症发生率分别为 27.5%和 8.0%（P=0.003），而在 MELD 评分>15 的亚组中，发生率分别为 53.3%和 20.0%（P=0.197）。
术前前白蛋白与 LT 术后并发症相关，术前营养支持有益于术后恢复，特别是对 MELD 评分较低的患者。
