The significance of the modified surgical apgar score in predicting postoperative acute kidney injury among patients undergoing hepatectomy

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease Pub Date : 2025-06-01 DOI:10.1016/j.dld.2025.01.207

Jiayu Feng , Rongdang Fu , Lei Zhang , Dong Yang , Hanbing Wang

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引用次数: 0

Abstract

Aim

The incidence of acute kidney injury (AKI) following hepatectomy ranges from 0.9 % to 21.6 %. Postoperative AKI is associated with increased mortality, prolonged hospital stays, and more healthcare costs. Previous predictive models either neglected intraoperative factors or were excessively complicated for application. Based on estimated blood loss, minimum heart rate, and minimum mean arterial pressure, the Surgical Apgar Score (SAS) has been validated as an indicator of major complications and outcomes following surgeries. Furthermore, previous studies have linked hematocrit levels to the incidence of AKI. Our aim was to determine whether the modified SAS, calculated using both SAS and hematocrit, could accurately predict AKI following hepatectomy.

Methods

This retrospective study ultimately enrolled 960 patients who underwent hepatectomy. The study included a total of 28 preoperative and intraoperative variables. Univariate and multivariate logistic regression analyses were performed to determine the predictive ability of the modified SAS.

Results

We demonstrated significant associations between the modified SAS and the incidence of AKI (OR 0.65, 95 % CI 0.54–0.78, p < 0.001). A lower total score increases the likelihood of postoperative AKI, with a cutoff value set at 9.

Conclusions

The modified SAS appears to be a valid predictive factor for AKI following hepatectomy.

查看原文本刊更多论文

改良手术apgar评分预测肝切除术患者术后急性肾损伤的意义。

目的：肝切除术后急性肾损伤（AKI）的发生率为0.9% ~ 21.6%。术后AKI与死亡率增加、住院时间延长和医疗费用增加有关。以往的预测模型要么忽略了术中因素，要么过于复杂，难以应用。基于估计的出血量、最小心率和最小平均动脉压，外科阿普加评分（SAS）已被证实是手术后主要并发症和预后的指标。此外，先前的研究已将红细胞压积水平与AKI的发生率联系起来。我们的目的是确定改良的SAS（同时使用SAS和红细胞压积计算）是否能准确预测肝切除术后的AKI。方法：这项回顾性研究最终纳入960例接受肝切除术的患者。该研究共包括28个术前和术中变量。进行单因素和多因素logistic回归分析，以确定改进的SAS的预测能力。结果：我们证实改良SAS与AKI发生率之间存在显著相关性（OR 0.65, 95% CI 0.54-0.78, p < 0.001）。总分越低，术后AKI发生的可能性越大，临界值为9。结论：改良的SAS似乎是肝切除术后AKI的有效预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.