caa a22 4500 445338989 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1829-6 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1829-6 The Predictive Value of Postoperative Clinical Risk Scores for Outcome After Hepatic Resection: A Validation Analysis in 807 Patients [Elektronische Daten] [Nuh Rahbari, Christoph Reissfelder, Moritz Koch, Heike Elbers, Fabian Striebel, Markus Büchler, Jürgen Weitz] Background: Although early postoperative risk stratification might allow a more precise prediction of outcomes after hepatic resection, evaluation of different postoperative clinical risk indices has been lacking. Methods: A total of 1,219 patients underwent hepatic resection between January 2002 and 2010, and 807 patients were eligible for final analyses. The model for end stage liver disease (MELD) score, the "50-50 criteria,” and the International Study Group of Liver Surgery (ISGLS) definition of posthepatectomy liver failure (PHLF) were assessed as clinical risk scores on postoperative day 5. Risk factors for morbidity and mortality were analyzed using multivariate logistic regression analyses. Results: The overall morbidity and mortality rates were 43 and 6%, respectively. Sensitivity of the MELD score, the 50-50 criteria and the PHLF for prediction of morbidity and mortality were 55, 6, 23 and 71, 26, 65%. On multivariate analyses MELD score [odds ratio (OR) 2.06; 95% confidence interval (95% CI) 1.41-3.02] and PHLF (5.61; 2.73-11.55) were associated with morbidity, whereas this association did not reach statistical significance for the 50-50 criteria (3.64; 0.78-17.02). The 50-50 criteria (16.45; 3.50-77.25) and PHLF (13.80; 4.27-44.61) were identified as powerful, independent predictors of mortality. This association was less strong for the MELD score (2.86; 0.98-8.31). Conclusion: Postoperative clinical risk scores are associated independently with outcome after hepatic resection. Owing to lack of sensitivity only the MELD score can be recommended for early prediction of overall morbidity, whereas the MELD score and the PHLF enabled adequate risk stratification regarding perioperative mortality. Society of Surgical Oncology, 2011 Rahbari Nuh Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Reissfelder Christoph Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Koch Moritz Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Elbers Heike Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Striebel Fabian Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Büchler Markus Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Weitz Jürgen Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3640-3649 1068-9265 18:13<3640 2011 18 10434 https://doi.org/10.1245/s10434-011-1829-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1829-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rahbari Nuh Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Reissfelder Christoph Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Koch Moritz Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Elbers Heike Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Striebel Fabian Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Büchler Markus Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Weitz Jürgen Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3640-3649 1068-9265 18:13<3640 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer