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Prognostic role of preoperative albumin-bilirubin score in posthepatectomy liver failure and mortality: a systematic review and meta-analysis

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Abstract

Posthepatectomy liver failure (PHLF) is a life-threatening complication after liver resection, resulting in an increased morbidity and mortality. Epidemiological evidence of the association between preoperative albumin-bilirubin (ALBI) score, a newly established model for assessing liver functional reserve, and the risk of PHLF and mortality remains controversial. A systematical search for relevant literature was performed in PubMed, Embase, and Web of Science databases from December 2014 to September 2020. Odds ratio (OR) value and 95% confidence interval (CI) were extracted or calculated to synthetically estimate the association of preoperative ALBI score with PHLF and mortality. Meta-analyses were performed using a random-effects model. Twelve studies with a total of 21,348 patients were included in this meta-analysis. It was indicated that, compared to patients with a lower preoperative ALBI grade, patients with a higher grade had a significantly elevated risk of PHLF (6 studies, 18,291 patients; OR = 2.48, 95%CI: 2.00–3.07) and mortality (4 studies15, 139 patients; OR = 2.35, 95% CI: 1.38–4.00). In addition, when it was expressed as a continuous variable, ALBI was also a significant predictor of PHLF (6 studies, 3,833 patients; OR = 3.16, 95% CI: 2.07–4.81, per 1-point increase in ALBI score). No significant publication biases were detected as suggested by funnel plots inspection and Begg’s tests. The current meta-analysis demonstrates that preoperative elevated ALBI is associated with higher risk of PHLF and mortality after hepatectomy.

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Funding

This work was supported by the Natural Science Foundation of Anhui Province for Outstanding Youth (No. 2008085J37), the First Affiliated Hospital of Bengbu Medical College Science Fund for Distinguished Young Scholars (No. 2019byyfyjq05), the 512 Talent Training Program of Bengbu Medical College for Excellent Young Teachers (No.51201318), and the National Nature Science Foundation of China (No. 81600452).

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  1. Qing Pang, Shuai Zhou and Shuangchi Liu contributed equally to this work.

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  1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, 233000, China

    Qing Pang, Shuai Zhou, Shuangchi Liu, Huichun Liu & Zheng Lu

  2. Department of General Surgery, Anhui No. 2 Provincial People’s Hospital, Hefei, Anhui, 230041, China

    Huichun Liu

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  1. Qing Pang
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Pang, Q., Zhou, S., Liu, S. et al. Prognostic role of preoperative albumin-bilirubin score in posthepatectomy liver failure and mortality: a systematic review and meta-analysis. Updates Surg 74, 821–831 (2022). https://doi.org/10.1007/s13304-021-01080-w

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