alexa Preoperative thrombocytopenia and outcomes of hepatectomy for hepatocellular carcinoma.
Biochemistry

Biochemistry

Biochemistry & Analytical Biochemistry

Author(s): Venkat R, Hannallah JR, Krouse RS, Maegawa FB

Abstract Share this page

Abstract BACKGROUND: Platelet count is known to be an indirect indicator of portal hypertension but is not a part of the model for end-stage liver disease (MELD) score or the Child-Pugh score for risk stratification in hepatobiliary surgery. METHODS: Data from 2097 hepatic resections for hepatocellular carcinoma (HCC) were evaluated from 2005-2012 using the National Surgical Quality Improvement Program database. Patient demographics, morbidity, and mortality were evaluated. RESULTS: Median age and body mass index were 64 y and 26.5 kg/m(2), respectively. Majority of the patients had American Society of Anesthesiologists ≥3 (78.1\%) and median MELD score was 7. On multivariate analysis, thrombocytopenia (platelet count <150/nL) and severe thrombocytopenia (platelet count <100/nL) were independently associated with an increased risk of mortality (odds ratio [OR], 1.79; P = 0.024 and OR, 4.19; P < 0.001), cardiopulmonary complications (OR, 1.61; P = 0.009 and OR, 1.96; P = 0.018), need for blood transfusion (OR, 1.35; P = 0.05 and OR, 1.60; P = 0.05), septic complications (OR, 1.53; P = 0.025 and OR, 1.96; P = 0.016), reintubation (OR, 1.91; P = 0.004 and OR, 2.64; P = 0.003), and renal insufficiency and/or failure (OR, 2.48; P = 0.001 and OR, 4.96; P < 0.001), respectively. CONCLUSIONS: Thrombocytopenia, which is an indirect indicator for portal hypertension, is significantly associated with adverse outcomes after hepatectomy, independent of the MELD score. Platelet count should be integrated into the selection criteria for hepatic resections for HCC. Published by Elsevier Inc. This article was published in J Surg Res and referenced in Biochemistry & Analytical Biochemistry

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords