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  • Capobianco, IvanUniv Hosp Tubingen, Germany (author)

Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-02
  • Hong Kong :AME Publishing Company,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-182651
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-182651URI
  • https://doi.org/10.21037/hbsn-21-396DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Oldhafer, Karl J.Asklepios Hosp Barmbek, Germany (author)
  • Fard-Aghaie, Mohammed-HosseinAsklepios Hosp Barmbek, Germany (author)
  • Robles-Campos, RicardoVirgen Arrixaca Clin, Spain; Univ Hosp, Spain (author)
  • Brusadin, RobertoVirgen Arrixaca Clin, Spain; Univ Hosp, Spain (author)
  • Petrowsky, HenrikZurich Univ Hosp, Switzerland (author)
  • Linecker, MichaelZurich Univ Hosp, Switzerland (author)
  • Mehrabi, ArianebHeidelberg Univ, Germany (author)
  • Hoffmann, KatrinHeidelberg Univ, Germany (author)
  • Li, JunHamburg Eppendorf Univ, Germany (author)
  • Heumann, AsmusHamburg Eppendorf Univ, Germany (author)
  • Hernandez-Alejandro, RobertoUniv Rochester, NY 14627 USA (author)
  • Tun-Abraham, Mauro EnriqueLondon Hlth Sci Ctr, Canada (author)
  • Jovine, ElioAzienda Ospedaliero Univ Bologna, Italy (author)
  • Serenari, MatteoAzienda Ospedaliero Univ Bologna, Italy (author)
  • Björnsson, BergthorLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)berbj34 (author)
  • Sandström, PerLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)persa07 (author)
  • Alikhanov, RuslanMoscow Clin Sci Ctr, Russia (author)
  • Efanov, MikhailMoscow Clin Sci Ctr, Russia (author)
  • Muiesan, PaoloUniv Hosp Birmingham NHS Fdn Trust, England (author)
  • Schlegel, AndreaUniv Hosp Birmingham NHS Fdn Trust, England (author)
  • Gulik, Thomas M. vanUniv Amsterdam, Netherlands (author)
  • Olthof, Pim B.Univ Amsterdam, Netherlands (author)
  • Stavrou, Gregor AlexanderSaarbruecken Gen Hosp, Germany (author)
  • Serna-Higulta, Lina MariaUniv Tubingen, Germany (author)
  • Königsrainer, AlfredUniv Hosp Tubingen, Germany (author)
  • Nadalin, SilvioUniv Hosp Tubingen, Germany (author)
  • Univ Hosp Tubingen, GermanyAsklepios Hosp Barmbek, Germany (creator_code:org_t)

Related titles

  • In:Hepatobiliary surgery and nutritionHong Kong : AME Publishing Company11:1, s. 52-662304-38812304-389X

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