Published online Jul 27, 2022. doi: 10.4240/wjgs.v14.i7.685
Peer-review started: March 25, 2022
First decision: May 29, 2022
Revised: June 5, 2022
Accepted: July 5, 2022
Article in press: July 5, 2022
Published online: July 27, 2022
Predicting, evaluating, and intervening in surgical risk and preventing pulmonary complications of liver surgery have become major clinical problems.
Postoperative pulmonary complications (PPCs) are important adverse events associated with surgery and anesthesia. At present, there is no perfect system to evaluate the risk of pulmonary complications following liver surgery using perioperative variables.
This study aimed to design and verify a risk assessment system for predicting PPCs after hepatectomy based on perioperative variables.
A retrospective analysis was performed on 1633 patients undergoing liver surgery. All factors that were significantly correlated with postoperative adverse outcomes were included in the multivariate logistic regression analysis. A scoring system [the liver operation pulmonary complication scoring system (LOPCSS)] was introduced based on the odds ratio (OR) values for these factors. The sum of the risk scores of all risk factors for a single patient was the total risk score of the patient’s complications. The cut-off value was used to determine the critical point of complications.
The independent factors influencing PPCs of liver surgery were age (≥ 65 years old/< 65 years old, OR = 1.926, P = 0.011), medical diseases requiring drug treatment (yes/no, OR = 3.523, P < 0.001), number of liver segments to be removed (≥ 3/≤ 2, OR = 1.683, P = 0.002), operation duration (≥ 180 min/< 180 min, OR = 1.896, P = 0.004), and blood transfusion (yes/no, OR = 1.836, P = 0.003). The cut-off value of the expected score for complications was 5.
As a novel and simplified assessment system, the LOPCSS can effectively predict PPCs of liver surgery using perioperative variables.
We screened for perioperative risk factors associated with pulmonary complications in liver surgery and established a scoring system to predict the occurrence of complications.