Zhong L, Wang HY, Li XN, Ling Q, Hao N, Li XY, Zhao GF, Liao M. Risk factors and predictive modeling of early postoperative liver function abnormalities. World J Hepatol 2025; 17(8): 108333 [DOI: 10.4254/wjh.v17.i8.108333]
Corresponding Author of This Article
Min Liao, Second Clinical Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou 510120, Guangdong Province, China. liaomin23@aliyun.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2025; 17(8): 108333 Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.108333
Risk factors and predictive modeling of early postoperative liver function abnormalities
Lin Zhong, Hao-Yuan Wang, Xiao-Na Li, Qiong Ling, Ning Hao, Xiang-Yu Li, Gao-Feng Zhao, Min Liao
Lin Zhong, Hao-Yuan Wang, Qiong Ling, Min Liao, Second Clinical Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Xiao-Na Li, Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Ning Hao, Xiang-Yu Li, Gao-Feng Zhao, Department of Anesthesiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Co-corresponding authors: Gao-Feng Zhao and Min Liao.
Author contributions: Zhong L and Liao M contributed to the conceptualization; Zhong L and Zhao GF were responsible for writing the original draft; Wang H-Y and Li X-N jointly conducted the formal analysis; Ling Q, Li XY, and Hao N collaborated on writing, reviewing, and editing; and all authors have read and approve the final manuscript.
Supported by Guangdong Provincial Hospital of Chinese Medicine Science and Technology Research Special Project, No. YN2023WSSQ01; and State Key Laboratory of Traditional Chinese Medicine Syndrome.
Institutional review board statement: This study was approved by the Provincial Hospital of Chinese Medicine on February 2, 2024 (approval number: YE2024-041-01).
Informed consent statement: The ethics committee waived the informed consent forms of all patients.
Conflict-of-interest statement: All authors declare that they have no competing financial interests or personal relationships that may have influenced the work reported in this study.
Data sharing statement: The datasets used and analyzed in the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Liao, Second Clinical Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou 510120, Guangdong Province, China. liaomin23@aliyun.com
Received: April 13, 2025 Revised: May 28, 2025 Accepted: July 21, 2025 Published online: August 27, 2025 Processing time: 137 Days and 5.3 Hours
Abstract
BACKGROUND
Research has shown that several factors can influence postoperative abnormal liver function; however, most studies on this issue have focused specifically on hepatic and cardiac surgeries, leaving limited research on contributing factors in other types of surgeries.
AIM
To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.
METHODS
This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine. Patients were divided into abnormal (n = 108) and normal (n = 3612) groups based on liver function post-surgery. Univariate analysis and LASSO regression screened variables, followed by logistic regression to identify risk factors. A prediction model was constructed based on the variables selected via logistic regression. The goodness-of-fit of the model was evaluated using the Hosmer–Lemeshow test, while discriminatory ability was measured by the area under the receiver operating characteristic curve. Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.
RESULTS
The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery, as well as the sevoflurane use during the procedure, among others.
CONCLUSION
The above factors collectively represent notable risk factors for postoperative liver function injury, and the prediction model developed based on these factors demonstrates strong predictive efficacy.
Core Tip: Elevated preoperative liver enzymes, thrombocytopenia, prolonged anesthesia and sevoflurane use are important risk factors for postoperative liver function abnormalities, and the prediction model constructed on the basis of these variables predicted well.
