Table 3.
Factors Associated with Post-Hepatectomy Death in Borderline Patients
| All Borderline Patients | No Death in 30 days |
Postoperative Death (30 days) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Clinical Characteristic | n or median | % or range | n or median | % | n or median | % or range | P | |||
| n | 3574 | 100% | 3442 | 96.3% | 132 | 3.7% | ||||
| Preoperative factors | ||||||||||
| Age | 74 | 17–90 | 74 | 17–90 | 76 | 29–90 | 0.830 | |||
| Previous cardiac surgery | 136 | 3.8% | 122 | 3.5% | 14 | 10.6% | <0.001 | |||
| Sodium <135 mEq/L | 417 | 11.7% | 391 | 11.4% | 26 | 19.7% | 0.003 | |||
| Albumin <3.5 g/dL | 744 | 20.8% | 687 | 20.0% | 57 | 43.2% | <0.001 | |||
| Alkaline phosphatase >93 IU/L | 1686 | 47.2% | 1601 | 46.5% | 85 | 64.4% | <0.001 | |||
| AST ≥30 IU/L | 1422 | 39.8% | 1346 | 39.1% | 76 | 57.6% | <0.001 | |||
| Bilirubin >1 mg/dL | 485 | 13.6% | 438 | 12.7% | 47 | 35.6% | <0.001 | |||
| WBC >11,000/μL | 298 | 8.3% | 283 | 8.2% | 15 | 11.4% | 0.200 | |||
| INR >1 | 1577 | 44.1% | 1501 | 43.6% | 76 | 57.6% | 0.002 | |||
| Platelets <150,000/μL | 502 | 14.0% | 473 | 13.7% | 29 | 22.0% | 0.008 | |||
| ASA class ≥3 | 2895 | 81.0% | 2779 | 80.7% | 116 | 87.9% | 0.040 | |||
| Disseminated cancer | 1297 | 36.3% | 1272 | 37.0% | 25 | 18.9% | <0.001 | |||
| Admitted ≥1day before operation | 449 | 12.6% | 417 | 12.1% | 32 | 24.2% | <0.001 | |||
| Intraoperative | ||||||||||
| Operative time, min | 217 | 19–1029 | 222 | 7–1045 | 268 | 67–891 | <0.001 | |||
| Operative time >240 min | 1505 | 42.1% | 1428 | 41.5% | 77 | 58.3% | <0.001 | |||
| Extent of hepatectomy | <0.001 | |||||||||
| Partial | 2166 | 60.6% | 2113 | 61.4% | 53 | 40.2% | ||||
| Left | 401 | 11.2% | 393 | 11.4% | 8 | 6.1% | ||||
| Right | 674 | 18.9% | 628 | 18.2% | 46 | 34.8% | ||||
| Extended | 333 | 9.3% | 308 | 8.9% | 25 | 18.9% | ||||
| Partial vs. Left/Right/Extended | 2166 | 60.6% | 2113 | 61.4% | 53 | 40.2% | <0.001 | |||
| Right/Extended vs. Left/Partial | <0.001 | |||||||||
| Right/Extended | 1007 | 28.2% | 936 | 27.2% | 71 | 53.8% | ||||
| Left/Partial | 2567 | 71.8% | 2506 | 72.8% | 61 | 46.2% | ||||
| Biliary repair/reconstruction | 241 | 6.7% | 219 | 6.4% | 22 | 16.7% | <0.001 | |||
| Another major abdominal operation | 558 | 15.6 | 527 | 15.3% | 31 | 23.5% | 0.011 | |||
| Postoperative | ||||||||||
| Any severe complication | 831 | 23.3% | 710 | 20.6% | 114 | 86.4% | <0.001 | |||
| ≥2 severe complications | 431 | 12.1% | 325 | 9.4% | 106 | 80.3% | <0.001 | |||
| ≥3 severe complications | 227 | 6.4% | 149 | 4.3% | 78 | 59.1% | <0.001 | |||
| Postoperative LOS, days (IQ Range) | 6 | (5–9) | 6 | (5–9) | 9 | (5–16.8) | <0.001 | |||
Abbreviations: AST, aspartate aminotransferase; WBC, white blood cells; INR, international normalized ratio; ASA, American Society of Anesthesiologists; LOS, length of stay
Not significant: gender, race, year of operation, body mass index, diabetes, smoker, alcohol use, dyspnea on exertion, previous coronary stent/angioplasty, medical hypertension, chemotherapy within 30 days, radiation therapy within 90 days, blood urea nitrogen, creatinine, hematocrit, partial thrombin time, chief resident involvement, operation in preceding 30 days, open wound