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Erschienen in: Langenbeck's Archives of Surgery 1/2023

01.12.2023 | Research

A preoperative risk score based on multifrequency bioelectrical impedance analysis in patients undergoing liver resection

verfasst von: Kazutaka Kojima, Junichi Shindoh, Masaru Matsumura, Satoshi Okubo, Masaji Hashimoto

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 1/2023

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Abstract

Purpose

To investigate if body composition parameters measured by bioelectrical impedance analysis (BIA) and are reportedly correlated with clinical outcomes of patients undergoing digestive tract surgery could be useful for reliably evaluating the perioperative risk in patients undergoing hepatectomy.

Methods

Consecutive 200 patients who underwent BIA before hepatectomy were retrospectively reviewed. A risk prediction model for postoperative morbidity was created using the initial 100 patients, and its performance was validated using the remaining 100 patients.

Results

Based on the correlation with postoperative morbidity, a novel risk prediction model, the protein-edema score, was created using net protein weight and extracellular water/total body water ratio measured through BIA. The protein-edema score (score 0 vs. ≥ 1) showed a reproducible correlation with Clavien–Dindo 2 or greater postoperative morbidity in the validation set (17.7% vs. 46.4%, P = 0.002) as observed in the training set (18.8% vs. 49.0%, P = 0.002) after statistical adjustment. Similar tendency was also confirmed in Clavien–Dindo 3a or greater postoperative morbidity (5.9% vs. 18.2%, P = 0.037) and postoperative refractory ascites (5.5% vs. 17.4%, P = 0.037) in the validation set.

Conclusions

The protein-edema score created based on BIA is significantly correlated with postoperative morbidity in patients undergoing liver resection.
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Literatur
1.
Zurück zum Zitat Dimick JB, Wainess RM, Cowan JA, Upchurch GR Jr, Knol JA, Colletti LM (2004) National trends in the use and outcomes of hepatic resection. J Am Coll Surg 199(1):31–38PubMedCrossRef Dimick JB, Wainess RM, Cowan JA, Upchurch GR Jr, Knol JA, Colletti LM (2004) National trends in the use and outcomes of hepatic resection. J Am Coll Surg 199(1):31–38PubMedCrossRef
2.
Zurück zum Zitat Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL et al (2015) Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol 33(6):550–558PubMedCrossRef Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL et al (2015) Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol 33(6):550–558PubMedCrossRef
3.
Zurück zum Zitat Kokudo T, Hasegawa K, Amikura K, Uldry E, Shirata C, Yamaguchi T et al (2016) Assessment of preoperative liver function in patients with hepatocellular carcinoma - the albumin-indocyanine green evaluation (ALICE) grade. PLoS One 11(7):e0159530PubMedPubMedCentralCrossRef Kokudo T, Hasegawa K, Amikura K, Uldry E, Shirata C, Yamaguchi T et al (2016) Assessment of preoperative liver function in patients with hepatocellular carcinoma - the albumin-indocyanine green evaluation (ALICE) grade. PLoS One 11(7):e0159530PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Shindoh J, Kawamura Y, Kobayashi Y, Kiya Y, Sugawara T, Akuta N et al (2019) Platelet-albumin score as a sensitive measure for surgical risk prediction and survival outcomes of patients with hepatocellular carcinoma. J Gastrointest Surg 23(1):76–83PubMedCrossRef Shindoh J, Kawamura Y, Kobayashi Y, Kiya Y, Sugawara T, Akuta N et al (2019) Platelet-albumin score as a sensitive measure for surgical risk prediction and survival outcomes of patients with hepatocellular carcinoma. J Gastrointest Surg 23(1):76–83PubMedCrossRef
5.
Zurück zum Zitat Ishizawa T, Hasegawa K, Aoki T, Takahashi M, Inoue Y, Sano K et al (2008) Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology 134(7):1908–1916PubMedCrossRef Ishizawa T, Hasegawa K, Aoki T, Takahashi M, Inoue Y, Sano K et al (2008) Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology 134(7):1908–1916PubMedCrossRef
6.
Zurück zum Zitat Umino R, Kobayashi Y, Akabane M, Kojima K, Okubo S, Hashimoto M, et al (2021) Preoperative nutritional score predicts underlying liver status and surgical risk of hepatocellular carcinoma. Scand J Surg 14574969211061953 Umino R, Kobayashi Y, Akabane M, Kojima K, Okubo S, Hashimoto M, et al (2021) Preoperative nutritional score predicts underlying liver status and surgical risk of hepatocellular carcinoma. Scand J Surg 14574969211061953
7.
Zurück zum Zitat Akabane M, Shindoh J, Kobayashi Y, Umino R, Kojima K, Okubo S et al (2021) Significance of preoperative nutritional status as a predictor for short-term and long-term outcomes of patients undergoing surgery for stage IV colorectal cancer. Langenbecks Arch Surg 406(7):2391–2398PubMedCrossRef Akabane M, Shindoh J, Kobayashi Y, Umino R, Kojima K, Okubo S et al (2021) Significance of preoperative nutritional status as a predictor for short-term and long-term outcomes of patients undergoing surgery for stage IV colorectal cancer. Langenbecks Arch Surg 406(7):2391–2398PubMedCrossRef
8.
Zurück zum Zitat Probst P, Fuchs J, Schon MR, Polychronidis G, Stravodimos C, Mehrabi A et al (2020) Prospective study to evaluate the prognostic value of different nutritional assessment scores in liver surgery: NURIMAS liver (DRKS00006340). Hepatobiliary Surg Nutr 9(4):400–413PubMedPubMedCentralCrossRef Probst P, Fuchs J, Schon MR, Polychronidis G, Stravodimos C, Mehrabi A et al (2020) Prospective study to evaluate the prognostic value of different nutritional assessment scores in liver surgery: NURIMAS liver (DRKS00006340). Hepatobiliary Surg Nutr 9(4):400–413PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9(7):629–635PubMedCrossRef Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9(7):629–635PubMedCrossRef
10.
Zurück zum Zitat Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC (2009) Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res 15(22):6973–6979PubMedCrossRef Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC (2009) Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res 15(22):6973–6979PubMedCrossRef
11.
Zurück zum Zitat Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE (2012) Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. Br J Cancer 107(6):931–936PubMedPubMedCentralCrossRef Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE (2012) Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. Br J Cancer 107(6):931–936PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Hamaguchi Y, Kaido T, Okumura S, Kobayashi A, Shirai H, Yao S et al (2019) Preoperative visceral adiposity and muscularity predict poor outcomes after hepatectomy for hepatocellular carcinoma. Liver Cancer 8(2):92–109PubMedCrossRef Hamaguchi Y, Kaido T, Okumura S, Kobayashi A, Shirai H, Yao S et al (2019) Preoperative visceral adiposity and muscularity predict poor outcomes after hepatectomy for hepatocellular carcinoma. Liver Cancer 8(2):92–109PubMedCrossRef
13.
Zurück zum Zitat Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y et al (2013) Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg 100(11):1523–1530PubMedCrossRef Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y et al (2013) Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg 100(11):1523–1530PubMedCrossRef
14.
Zurück zum Zitat Ida S, Watanabe M, Karashima R, Imamura Y, Ishimoto T, Baba Y et al (2014) Changes in body composition secondary to neoadjuvant chemotherapy for advanced esophageal cancer are related to the occurrence of postoperative complications after esophagectomy. Ann Surg Oncol 21(11):3675–3679PubMedCrossRef Ida S, Watanabe M, Karashima R, Imamura Y, Ishimoto T, Baba Y et al (2014) Changes in body composition secondary to neoadjuvant chemotherapy for advanced esophageal cancer are related to the occurrence of postoperative complications after esophagectomy. Ann Surg Oncol 21(11):3675–3679PubMedCrossRef
15.
Zurück zum Zitat Ida S, Watanabe M, Yoshida N, Baba Y, Umezaki N, Harada K et al (2015) Sarcopenia is a predictor of postoperative respiratory complications in patients with esophageal cancer. Ann Surg Oncol 22(13):4432–4437PubMedCrossRef Ida S, Watanabe M, Yoshida N, Baba Y, Umezaki N, Harada K et al (2015) Sarcopenia is a predictor of postoperative respiratory complications in patients with esophageal cancer. Ann Surg Oncol 22(13):4432–4437PubMedCrossRef
16.
Zurück zum Zitat Kaido T, Mori A, Ogura Y, Ogawa K, Hata K, Yoshizawa A et al (2012) Pre- and perioperative factors affecting infection after living donor liver transplantation. Nutrition 28(11–12):1104–1108PubMedCrossRef Kaido T, Mori A, Ogura Y, Ogawa K, Hata K, Yoshizawa A et al (2012) Pre- and perioperative factors affecting infection after living donor liver transplantation. Nutrition 28(11–12):1104–1108PubMedCrossRef
17.
Zurück zum Zitat Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2003) Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer 89(6):1028–1030PubMedPubMedCentralCrossRef Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2003) Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer 89(6):1028–1030PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A et al (2005) CONUT: a tool for controlling nutritional status First validation in a hospital population. Nutr Hosp 20(1):38–45PubMed Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A et al (2005) CONUT: a tool for controlling nutritional status First validation in a hospital population. Nutr Hosp 20(1):38–45PubMed
19.
Zurück zum Zitat Kobayashi Y, Kiya Y, Sugawara T, Nishioka Y, Hashimoto M, Shindoh J (2019) Expanded Makuuchi's criteria using estimated indocyanine green clearance rate of future liver remnant as a safety limit for maximum extent of liver resection. HPB 21(8):990–997 Kobayashi Y, Kiya Y, Sugawara T, Nishioka Y, Hashimoto M, Shindoh J (2019) Expanded Makuuchi's criteria using estimated indocyanine green clearance rate of future liver remnant as a safety limit for maximum extent of liver resection. HPB 21(8):990–997
20.
Zurück zum Zitat Kobayashi Y, Kiya Y, Nishioka Y, Hashimoto M, Shindoh J (2019) Indocyanine green clearance of remnant liver (ICG-Krem) predicts postoperative subclinical hepatic insufficiency after resection of colorectal liver metastasis: theoretical validation for safe expansion of Makuuchi's criteria. HPB 22(2):258–264 Kobayashi Y, Kiya Y, Nishioka Y, Hashimoto M, Shindoh J (2019) Indocyanine green clearance of remnant liver (ICG-Krem) predicts postoperative subclinical hepatic insufficiency after resection of colorectal liver metastasis: theoretical validation for safe expansion of Makuuchi's criteria. HPB 22(2):258–264
21.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196PubMedCrossRef Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196PubMedCrossRef
22.
Zurück zum Zitat McLester CN, Nickerson BS, Kliszczewicz BM, McLester JR (2020) Reliability and agreement of various InBody body composition analyzers as compared to dual-energy X-ray absorptiometry in healthy men and women. J Clin Densitom 23(3):443–450PubMedCrossRef McLester CN, Nickerson BS, Kliszczewicz BM, McLester JR (2020) Reliability and agreement of various InBody body composition analyzers as compared to dual-energy X-ray absorptiometry in healthy men and women. J Clin Densitom 23(3):443–450PubMedCrossRef
23.
Zurück zum Zitat Lee SY, Ahn S, Kim YJ, Ji MJ, Kim KM, Choi SH, et al (2018) Comparison between dual-energy X-ray absorptiometry and bioelectrical impedance analyses for accuracy in measuring whole body muscle mass and appendicular skeletal muscle mass. Nutrients 10(6):738 Lee SY, Ahn S, Kim YJ, Ji MJ, Kim KM, Choi SH, et al (2018) Comparison between dual-energy X-ray absorptiometry and bioelectrical impedance analyses for accuracy in measuring whole body muscle mass and appendicular skeletal muscle mass. Nutrients 10(6):738
24.
Zurück zum Zitat Shafer KJ, Siders WA, Johnson LK, Lukaski HC (2009) Validity of segmental multiple-frequency bioelectrical impedance analysis to estimate body composition of adults across a range of body mass indexes. Nutrition 25(1):25–32PubMedCrossRef Shafer KJ, Siders WA, Johnson LK, Lukaski HC (2009) Validity of segmental multiple-frequency bioelectrical impedance analysis to estimate body composition of adults across a range of body mass indexes. Nutrition 25(1):25–32PubMedCrossRef
25.
Zurück zum Zitat Jensky-Squires NE, Dieli-Conwright CM, Rossuello A, Erceg DN, McCauley S, Schroeder ET (2008) Validity and reliability of body composition analysers in children and adults. Br J Nutr 100(4):859–865PubMedCrossRef Jensky-Squires NE, Dieli-Conwright CM, Rossuello A, Erceg DN, McCauley S, Schroeder ET (2008) Validity and reliability of body composition analysers in children and adults. Br J Nutr 100(4):859–865PubMedCrossRef
26.
Zurück zum Zitat Bedogni G, Malavolti M, Severi S, Poli M, Mussi C, Fantuzzi AL et al (2002) Accuracy of an eight-point tactile-electrode impedance method in the assessment of total body water. Eur J Clin Nutr 56(11):1143–1148PubMedCrossRef Bedogni G, Malavolti M, Severi S, Poli M, Mussi C, Fantuzzi AL et al (2002) Accuracy of an eight-point tactile-electrode impedance method in the assessment of total body water. Eur J Clin Nutr 56(11):1143–1148PubMedCrossRef
Metadaten
Titel
A preoperative risk score based on multifrequency bioelectrical impedance analysis in patients undergoing liver resection
verfasst von
Kazutaka Kojima
Junichi Shindoh
Masaru Matsumura
Satoshi Okubo
Masaji Hashimoto
Publikationsdatum
01.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 1/2023
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-023-02806-7

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