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A Case for Data: Improving Surgical Performance and Patient Outcomes Through an Evidence-based Approach to List Ordering by T. Pike; F. Mushtaq; R. Mann; R. Wilkie; M. Mon-Williams; J.P.A. Lodge is a Medicine article available to read on EtoBox.

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into a derivation or validation cohort. We developed a score based on preoperative variables using ROC analyses to identify cut-off values, then testing the variables using multivariate analyses. The significant independent variables were used to build the score. Analyses were performed following the TRIPOD statement. Results: 340 patients were included, 240 in the derivation cohort and 100 in the validation cohort. ROC analysis identified patients with liver stiffness !9.7 kPa (AUC=0.728, Se=88.9%, Sp=67.3%; P=0.031) and steatosis !250 dB/m/MHz (AUC=0.656, Se=80%,Sp=60%; P=0.045) as those at greater risk of complications. Multivariate analysis showed that major hepatectomy (OR=2.01; P=0.001), stiffness !9.7 kPa (OR=2.8; P=0.001), BILCHE score !2 (OR=3; P=0.001) and presence of esophageal varices (OR=1.98; P=0.002) were independent predictors of complications. A 10-point scoring system was introduced. Patients with 4 points did not experience complications, whereas patients with !7 experienced up to 46% of complications (P<0.001). Conclusion: A simple and clinically reliable surgical score based on stiffness, BILCHE score, type of hepatectomy and presence of varices was developed,

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Author

T. Pike; F. Mushtaq; R. Mann; R. Wilkie; M. Mon-Williams; J.P.A. Lodge

Publisher

John Wiley and Sons; Elsevier ; Elsevier Limited; Elsevier BV; Wiley (ISSN 1365-182X)

Published

2019

Language

EN

Field

Medicine (Health Sciences)