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 : 2025-02-20 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.

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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.