Renal Dysfunction Is an Independent Risk Factor for Mortality after Liver Resection and the Main Determinant of Outcome in Posthepatectomy Liver Failure
Table 4
Univariate and multivariate analysis of preoperative and operative factors as well as postoperative blood tests associated with 90-day mortality following liver resection in 495 patients.
Univariate
Multivariate
Factor (preoperative and operative factors and postoperative blood tests)
Coef (95% CI)
P value
Coef (95% CI)
P value
Age
1.05 (1.01–1.10)
0.029*
0.194
Gender
2.36 (0.91–6.08)
0.077*
0.196
Pathology
0.274
Liver directed chemotherapy
0.356
Diabetic
3.09 (1.16–8.20)
0.024*
3.41 (1.14–10.23)
0.028**
BMI
0.444
ASA grade
1 versus 2
3.02 (0.70–13.11)
0.139*
0.678
2 versus 3
0.724
Physiologic score
1.12 (1.03–1.22)
0.010*
0.544
Operative score
0.303
P-POSSUM mortality
1.04 (1.01–1.07)
0.010*
0.479
Fibrosis/cirrhosis
0.986
Preoperative bilirubin
1.01 (1.00–1.03)
0.081*
0.652
Preoperative haemoglobin
0.71 (0.55–0.93)
0.012*
0.195
Preoperative white cell count
0.388
Preoperative albumin
0.90 (0.84–0.96)
0.002*
0.168
Preoperative alkaline phosphatase
0.884
Preoperative creatinine
1.01 (1.00–1.02)
0.098*
0.764
Preoperative neutrophil lymphocyte ratio
1.13 (0.98–1.31)
0.086*
0.366
Preoperative neutrophil lymphocyte ratio >5
2.18 (0.78–6.11)
0.138*
0.345
Open or laparoscopic resection
0.987
Radiofrequency ablation (RFA) included
0.991
Wedge resection included
0.588
Bile duct reconstruction included
2.96 (1.05–8.39)
0.041*
0.383
Synchronous bowel procedure
0.346
Operation number
0.549
Number of segments resected
1.59 (1.18–2.14)
0.003*
0.075
Number of procedures
0.786
Surgeons assessment of liver parenchyma
2.14 (0.92–4.96)
0.076*
0.494
Blood loss (mL)
<500 versus >500
2.67 (1.27–5.61)
0.009*
0.716
>500 versus >1000
0.652
Units of red cells transfused
1.13 (1.02–1.26)
0.023*
0.224
PHLF at POD 5
1.02 (1.01–1.03)
<0.001*
4.51 (1.42–14.40)
0.011**
Renal dysfunction (creatinine rise >1.5x)
1.02 (1.01–1.03)
<0.001*
3.63 (1.13–11.66)
0.030**
Significant at the level of 0.25 for univariate analysis and included in multivariate analysis. Significant at the level of 0.05 for multivariate analysis.
