Clinical utility of surgical apgar score for predicting complications after hepatectomy for hepatocellular carcinoma

Abstract

in relation to RR (full line) and PP (dashed line) by size of PH pre-and post-operative.We found that early phase of rat liver regeneration is characterized by an increase in hVOL. Only after 70% and 90% PH is hyperplasia superseded by hypertrophy; more pronounced the larger PH. This dynamic pattern may reflect the differences in requirements and adaption in order for the future liver remnant to maintain body homeostasis and to regenerate. Introduction: Surgical Apgar score (SAS) has been recently proposed as a simple predictor of postoperative complications. Some studies have shown utility of the scoring system in some kinds of surgeries. To date, however, SAS has not been investigated in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Methods: This study included 158 consecutive patients undergoing hepatectomy for HCC in our institution. Association between SAS and postoperative complications was examined in the patients. The patients had postoperative morbidities classified as Clavien-Dindo grade II or higher. Multivariate regression analysis was performed to identify independent factors that significantly influenced the development of postoperative complications. Results: Postoperative complications developed in 28 (17.7%) of the 158 patients. The proportion of cases with complications significantly inversely correlated with SAS (Spearman rank correlation 0.829). SAS was significantly lower in cases with complications than those without complications (5.6 AE 1.3 points vs. 6.6 AE 1.3 points, p = 0.0004). Comparisons of patients with and without complication showed that preoperative serum albumin level and operation time, as well as SAS, were associated with complications. Multivariate analysis revealed that postoperative complications significantly correlated with SAS. Conclusion: This study demonstrated the clinical utility of SAS in predicting the development of postoperative complications after hepatectomy for HCC.