A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis
Ting Sun,1 Tao Wang,1 Yiwen Qiu,1 Shu Shen,1 Xianwei Yang,1 Yi Yang,1 Bin Huang,2 Wentao Wang1 1Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Vascular Surgery, West China Hospital of Sich...
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Dove Medical Press
2021
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oai:doaj.org-article:b0b7185fde06435296321b85301f000d2021-11-23T18:43:01ZA Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis1178-6973https://doaj.org/article/b0b7185fde06435296321b85301f000d2021-11-01T00:00:00Zhttps://www.dovepress.com/a-sarcopenia-based-prediction-model-for-postoperative-complications-of-peer-reviewed-fulltext-article-IDRhttps://doaj.org/toc/1178-6973Ting Sun,1 Tao Wang,1 Yiwen Qiu,1 Shu Shen,1 Xianwei Yang,1 Yi Yang,1 Bin Huang,2 Wentao Wang1 1Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Wentao Wang Email wwtdoctor02@163.comBackground: Sarcopenia and visceral adiposity have been shown to be associated with postoperative complications in numerous diseases. However, their effects on the postoperative complications of end-stage hepatic alveolar echinococcosis (HAE) patients undergoing ex vivo liver resection and autotransplantation (ELRA) remain unclear.Methods: This retrospective study included 101 end-stage HAE patients who underwent ELRA from January 2014 to August 2020. We measured the skeletal muscle and adipose tissue of all patients at the level of the third lumbar vertebra on plain abdominal computed tomography (CT) images and subsequently derived an equation via least absolute shrinkage and selection operator (LASSO) regression analysis to calculate the sarcopenia score. Univariate and multivariate regression were performed to reveal the relationship between major postoperative complications and perioperative clinical data, and the obtained nomogram was validated with the bootstrapping method.Results: The sarcopenia score was constructed as a personalized indicator to evaluate sarcopenia and visceral adiposity in each patient. Logistic regression analysis finally selected duration from primary diagnosis to obvious symptoms (OR=1.024, 95% CI, 1.007– 1.042), surgical time (OR=1.003, 95% CI, 0.999– 1.007) and sarcopenia score (OR=4.283, 95% CI, 1.739– 10.551) as independent risk factors for predicting major postoperative complications following ELRA for end-stage HAE patients. The area under the receiver operating characteristic curve (AUROC) of 0.807 (95% CI, 0.720– 0.895) and the calibration curve for this prediction model were satisfactory.Conclusion: The sarcopenia score, which systematically evaluates the skeletal muscle and adipose tissue of end-stage HAE patients, was a significant predictive factor for major postoperative complications of ELRA. Relevant interventions should be conducted for those who have a high risk of postoperative complications according to the nomogram.Keywords: hepatic alveolar echinococcosis, liver transplantation, hepatectomy, sarcopenia, postoperative complicationsSun TWang TQiu YShen SYang XYang YHuang BWang WDove Medical Pressarticlehepatic alveolar echinococcosisliver transplantationhepatectomysarcopeniapostoperative complicationsInfectious and parasitic diseasesRC109-216ENInfection and Drug Resistance, Vol Volume 14, Pp 4887-4901 (2021) |
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DOAJ |
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hepatic alveolar echinococcosis liver transplantation hepatectomy sarcopenia postoperative complications Infectious and parasitic diseases RC109-216 |
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hepatic alveolar echinococcosis liver transplantation hepatectomy sarcopenia postoperative complications Infectious and parasitic diseases RC109-216 Sun T Wang T Qiu Y Shen S Yang X Yang Y Huang B Wang W A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| description |
Ting Sun,1 Tao Wang,1 Yiwen Qiu,1 Shu Shen,1 Xianwei Yang,1 Yi Yang,1 Bin Huang,2 Wentao Wang1 1Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Wentao Wang Email wwtdoctor02@163.comBackground: Sarcopenia and visceral adiposity have been shown to be associated with postoperative complications in numerous diseases. However, their effects on the postoperative complications of end-stage hepatic alveolar echinococcosis (HAE) patients undergoing ex vivo liver resection and autotransplantation (ELRA) remain unclear.Methods: This retrospective study included 101 end-stage HAE patients who underwent ELRA from January 2014 to August 2020. We measured the skeletal muscle and adipose tissue of all patients at the level of the third lumbar vertebra on plain abdominal computed tomography (CT) images and subsequently derived an equation via least absolute shrinkage and selection operator (LASSO) regression analysis to calculate the sarcopenia score. Univariate and multivariate regression were performed to reveal the relationship between major postoperative complications and perioperative clinical data, and the obtained nomogram was validated with the bootstrapping method.Results: The sarcopenia score was constructed as a personalized indicator to evaluate sarcopenia and visceral adiposity in each patient. Logistic regression analysis finally selected duration from primary diagnosis to obvious symptoms (OR=1.024, 95% CI, 1.007– 1.042), surgical time (OR=1.003, 95% CI, 0.999– 1.007) and sarcopenia score (OR=4.283, 95% CI, 1.739– 10.551) as independent risk factors for predicting major postoperative complications following ELRA for end-stage HAE patients. The area under the receiver operating characteristic curve (AUROC) of 0.807 (95% CI, 0.720– 0.895) and the calibration curve for this prediction model were satisfactory.Conclusion: The sarcopenia score, which systematically evaluates the skeletal muscle and adipose tissue of end-stage HAE patients, was a significant predictive factor for major postoperative complications of ELRA. Relevant interventions should be conducted for those who have a high risk of postoperative complications according to the nomogram.Keywords: hepatic alveolar echinococcosis, liver transplantation, hepatectomy, sarcopenia, postoperative complications |
| format |
article |
| author |
Sun T Wang T Qiu Y Shen S Yang X Yang Y Huang B Wang W |
| author_facet |
Sun T Wang T Qiu Y Shen S Yang X Yang Y Huang B Wang W |
| author_sort |
Sun T |
| title |
A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| title_short |
A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| title_full |
A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| title_fullStr |
A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| title_full_unstemmed |
A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis |
| title_sort |
sarcopenia-based prediction model for postoperative complications of ex vivo liver resection and autotransplantation to treat end-stage hepatic alveolar echinococcosis |
| publisher |
Dove Medical Press |
| publishDate |
2021 |
| url |
https://doaj.org/article/b0b7185fde06435296321b85301f000d |
| work_keys_str_mv |
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