Long-term diuretic medication is an independent predictor of posthepatectomy liver failure

IF 2.2 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery Pub Date : 2025-03-26 DOI:10.1016/j.gassur.2025.102035

Alexander Betzler , Johanna Betzler , Andreas Bogner , Elene Walther , Mohammad Rahbari , Christoph Reissfelder , Carina Riediger , Jürgen Weitz , Nuh N. Rahbari , Emrullah Birgin

{"title":"Long-term diuretic medication is an independent predictor of posthepatectomy liver failure","authors":"Alexander Betzler , Johanna Betzler , Andreas Bogner , Elene Walther , Mohammad Rahbari , Christoph Reissfelder , Carina Riediger , Jürgen Weitz , Nuh N. Rahbari , Emrullah Birgin","doi":"10.1016/j.gassur.2025.102035","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Posthepatectomy liver failure (PHLF) is the most fatal complication after liver resection, particularly in patients with comorbidities. This study aimed to assess the effect of long-term medication on PHLF incidence after open liver resections.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 682 patients who underwent elective open hepatectomies between 2008 and 2015 at 2 academic centers was performed. Preoperative, intraoperative, and postoperative data were collected, including long-term medication. The risk factors for the development of PHLF and other postoperative complications were evaluated using univariate and multivariate logistic regression analyses.</div></div><div><h3>Results</h3><div>PHLF occurred in 81 patients (11.9%), with a higher incidence in patients taking diuretics as long-term medication than in those not taking diuretics (17.7% vs 5.3%, respectively; <em>P</em> <.001). Diuretic use was identified as a strong independent risk factor for <em>P</em>HLF (odds ratio [OR], 3.8 [95% CI, 2.1–7.0]; <em>P</em> <.001), alongside liver cirrhosis (OR, 3.8 [95% CI, 1.9–7.6]; <em>P</em> <.001), primary liver malignancies (OR, 3.8 [95% CI, 1.6–9.3]; <em>P</em> <.001), major hepatectomies (OR, 3.1 [95% CI, 1.7–5.7]; <em>P</em> <.001), and long operating time (OR, 4.2 [95% CI, 2.4–7.2]; <em>P</em> <.001). Patients with long-term diuretic intake were older, had higher body mass indices, and had more comorbidities, including liver cirrhosis.</div></div><div><h3>Conclusion</h3><div>Long-term diuretic use is associated with a significantly increased risk of PHLF after open hepatectomy.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102035"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1091255X25000940","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Posthepatectomy liver failure (PHLF) is the most fatal complication after liver resection, particularly in patients with comorbidities. This study aimed to assess the effect of long-term medication on PHLF incidence after open liver resections.

Methods

A retrospective analysis of 682 patients who underwent elective open hepatectomies between 2008 and 2015 at 2 academic centers was performed. Preoperative, intraoperative, and postoperative data were collected, including long-term medication. The risk factors for the development of PHLF and other postoperative complications were evaluated using univariate and multivariate logistic regression analyses.

Results

PHLF occurred in 81 patients (11.9%), with a higher incidence in patients taking diuretics as long-term medication than in those not taking diuretics (17.7% vs 5.3%, respectively; P <.001). Diuretic use was identified as a strong independent risk factor for PHLF (odds ratio [OR], 3.8 [95% CI, 2.1–7.0]; P <.001), alongside liver cirrhosis (OR, 3.8 [95% CI, 1.9–7.6]; P <.001), primary liver malignancies (OR, 3.8 [95% CI, 1.6–9.3]; P <.001), major hepatectomies (OR, 3.1 [95% CI, 1.7–5.7]; P <.001), and long operating time (OR, 4.2 [95% CI, 2.4–7.2]; P <.001). Patients with long-term diuretic intake were older, had higher body mass indices, and had more comorbidities, including liver cirrhosis.

Conclusion

Long-term diuretic use is associated with a significantly increased risk of PHLF after open hepatectomy.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastrointestinal Surgery 医学-外科

CiteScore

5.50

自引率

3.10%

发文量

319

审稿时长

2 months

期刊介绍： The Journal of Gastrointestinal Surgery is a scholarly, peer-reviewed journal that updates the surgeon on the latest developments in gastrointestinal surgery. The journal includes original articles on surgery of the digestive tract; gastrointestinal images; "How I Do It" articles, subject reviews, book reports, editorial columns, the SSAT Presidential Address, articles by a guest orator, symposia, letters, results of conferences and more. This is the official publication of the Society for Surgery of the Alimentary Tract. The journal functions as an outstanding forum for continuing education in surgery and diseases of the gastrointestinal tract.