Predictive Value Of ALBI Score And PALBI Score In Assessing The Risk Of Complications Of Liver Insufficiency Or Liver Failure After Hepatectomy

Objective:To explore the predictive value of ALBI score and PALBI score in evaluating the risk of liver insufficiency or liver failure complications after hepatectomy by comparing the recovery status of primary hepatocellular carcinoma patients after partial hepatectomy and whether the status of liver insufficiency or liver failure complicated with hepatectomy was determined according to the "50-50 criteria".Methods:The clinical data of 106 patients who received partial liver resection in the First Hospital of Shanxi Medical University from April 2018 to January 2023 were retrospectively analyzed.According to the 50-50 criteria,the 106 recipients were divided into two groups: postoperative hepatic insufficiency or hepatic failure and non-postoperative hepatic insufficiency or hepatic failure.The changes of postoperative serological detection indexes were compared between the two groups.Results:Among the 106 HCC patients who underwent partial hepatectomy included in this study,13 had PLD or PHLFand 93 did not.In the univariate analysis of patient test data,there were statistically significant differences in AST,gamma-GT,TBil,albumin,tumor maximum diameter,Child-Pugh score,ALBI score and PALBI score between the two groups(P < 0.05).There were no significant differences in ALT,age,sex,hepatitis B DNA,preoperative AFP,operation time,or conversion to laparotomy between the two groups(P > 0.05).The results of multivariate analysis on the above meaningful difference indicators show that: Child-Pugh score、ALBI score and PALBI score could be used as independent factors to determine whether PLD or PHLF occurred in patients(P< 0.05),while AST,gamma-GT and tumor maximum diameter could not be used as significant factors to determine whether PLD or PHLF occurred in patients(P > 0.05).The area under ROC curve of Child-Pugh score was 0.647(95% confidence interval:0.548～0.738),and the area under ROC curve of ALBI score was 0.791(95%confidence interval: 0.701～0.864).The area under ROC curve of PALBI score was 0.794(95% confidence interval: 0.704～0.866).The optimal threshold of Child-Pugh score for predicting PLD or PHLF in HCC patients was 6.500,the sensitivity was 38.5%,and the specificity was 92.5%.The optimal critical value of ALBI score for predicting PLD or PHLF in HCC patients was-2.345,the sensitivity was 76.9%,and the specificity was77.4%.The optimal threshold value of PALBI score for predicting PLD or PHLF in HCC patients was-2.050,the sensitivity was 69.2%,and the specificity was 92.5%.Conclusions:1.Both ALBI score and PALBI score had predictive value for PLD or PHLF after hepatectomy.2.ALBI score >-2.345 and PALBI score >-2.050 were risk factors for PLD or PHLF after hepatectomy.3.The predictive efficacy of PLD or PHLF after hepatectomy was both PALBI score and ALBI score are better than Child-Pugh score.