Qin Feng-Fei, Deng Feng-Lian, Huang Cui-Ting, Lin Shu-Li, Huang Hui, Nong Jie-Jin, Wei Mei-Juan
Department of Infectious Diseases, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China.
Department of Renal Diseases, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2127-2134. doi: 10.4240/wjgs.v16.i7.2127.
Post-hepatectomy liver failure (PHLF) is the most common postoperative complication and the leading cause of death after hepatectomy. The albumin-bilirubin (ALBI) score and nutritional risk index (NRI) have been shown to assess end-stage liver disease and predict PHLF and patient survival. We hypothesized that the ALBI score and NRI interact in the prediction of PHLF.
To analyze the interaction between the ALBI score and NRI in PHLF in patients with hepatocellular carcinoma.
This retrospective study included 186 patients who underwent hepatectomy for hepatocellular carcinoma at the Affiliated Hospital of Youjiang Medical University for Nationalities between January 2020 and July 2023. Data on patient characteristics and laboratory indices were collected from their medical records. Univariate and multivariate logistic regression were performed to determine the interaction effect between the ALBI score and NRI in PHLF.
Of the 186 patients included in the study, PHLF occurred in 44 (23.66%). After adjusting for confounders, multivariate logistic regression identified ALBI grade 2/3 [odds ratio (OR) = 73.713, 95% confidence interval (CI): 9.175-592.199] and NRI > 97.5 (OR = 58.990, 95%CI: 7.337-474.297) as risk factors for PHLF. No multiplicative interaction was observed between the ALBI score and NRI (OR = 0.357, 95%CI: 0.022-5.889). However, the risk of PHLF in patients with ALBI grade 2/3 and NRI < 97.5 was 101 times greater than that in patients with ALBI grade 1 and NRI ≥ 97.5 (95%CI: 56.445-523.839), indicating a significant additive interaction between the ALBI score and NRI in PHLF.
Both the ALBI score and NRI were risk factors for PHLF, and there was an additive interaction between the ALBI score and NRI in PHLF.
肝切除术后肝衰竭（PHLF）是肝切除术后最常见的并发症及主要死亡原因。白蛋白-胆红素（ALBI）评分和营养风险指数（NRI）已被证明可用于评估终末期肝病，并预测PHLF及患者生存情况。我们假设ALBI评分和NRI在预测PHLF方面存在相互作用。
分析肝细胞癌患者中ALBI评分与NRI在PHLF中的相互作用。
这项回顾性研究纳入了2020年1月至2023年7月期间在右江民族医学院附属医院接受肝细胞癌肝切除术的186例患者。从他们的病历中收集患者特征和实验室指标数据。进行单因素和多因素逻辑回归分析，以确定ALBI评分与NRI在PHLF中的相互作用效应。
在纳入研究的186例患者中，44例（23.66%）发生了PHLF。在调整混杂因素后，多因素逻辑回归分析确定ALBI 2/3级（比值比[OR]=73.713，95%置信区间[CI]：9.175-592.199）和NRI>97.5（OR=58.990，95%CI：7.337-474.297）为PHLF的危险因素。未观察到ALBI评分与NRI之间存在相乘交互作用（OR=0.357，95%CI：0.022-5.889）。然而，ALBI 2/3级且NRI<97.5的患者发生PHLF的风险比ALBI 1级且NRI≥97.5的患者高101倍（95%CI：56.445-523.839），这表明ALBI评分与NRI在PHLF中存在显著的相加交互作用。
ALBI评分和NRI均为PHLF的危险因素，且在PHLF中ALBI评分与NRI之间存在相加交互作用。
