Establishment of a risk assessment system for complications of hepatectomy based on preoperative variables

Background and aims:To reduce the incidence of postoperative complications,it is important to predict them and intervene before surgery if necessary.However,there is no ideal system to evaluate the overall risk of post-operative complications of liver surgery on the basis of preoperative variables.Therefore,this study aimed to design and validate a risk assessment system to predict postoperative complications of hepatectomy on the basis of preoperative variables.Methods:Binomial logistic regression was used to derive the“hepatectomy overall risk formula”(HORF)for predicting postoperative complications on the basis of preoperative variables.Results:Multivariate analysis revealed that Child–Pugh grade B–C(odds ratio[OR]=1.984,p=0.002),medical diseases requiring drug treatment(OR=1.883,p=0.003),major hepatectomy(OR=1.947,p<0.001),adjacent organ invasion(OR¼3.616,p¼0.023),and preoperative hospital stay>7 days(OR=1.565,p=0.004)were independent risk factors for postoperative complications of hepatectomy.The area under the curve for the HORF was 0.736.The optimal cut-off value for predicting complications was 0.32(32%).The area under the curve for the HORF in the validation dataset was 0.727.Conclusion:The HORF can accurately predict postoperative complications of hepatectomy on the basis of pre-operative variables,and thus enables the determination of the necessity for intervention before surgery.