Evidence map›Paper›PMID 27506991›Full record

ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2016

Validation of the peak bilirubin criterion for outcome after partial hepatectomy.

Kim M C van Mierlo, Toine M Lodewick, Dipok K Dhar, Victor van Woerden, Ralph Kurstjens, Frank G Schaap, Ronald M van Dam, Soumil Vyas, Massimo Malagó, Cornelis H C Dejong and 1 more

Abstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kim M C van MierloDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands.
Toine M LodewickDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands; Department of Surgery, University Hospital Aachen, Division of General, Visceral and Transplantation Surgery, Aachen, Germany.
Dipok K DharDepartment of Surgery, Royal Free & Institute for Liver and Digestive Health University College London Hospitals, and University College London, London, United Kingdom; Organ Transplantation Centre and Comparative Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Victor van WoerdenDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands.
Ralph KurstjensDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands.
Frank G SchaapDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands.
Ronald M van DamDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands.
Soumil VyasDepartment of Surgery, Royal Free & Institute for Liver and Digestive Health University College London Hospitals, and University College London, London, United Kingdom.
Massimo MalagóDepartment of Surgery, Royal Free & Institute for Liver and Digestive Health University College London Hospitals, and University College London, London, United Kingdom.
Cornelis H C DejongDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Steven W M Olde DaminkDepartment of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research, Maastricht University, Maastricht, The Netherlands; Department of Surgery, Royal Free & Institute for Liver and Digestive Health University College London Hospitals, and University College London, London, United Kingdom. Electronic address: steven.oldedamink@maastrichtuniversity.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPostoperative liver failure (PLF) is a dreaded complication after partial hepatectomy. The peak bilirubin criterion (>7.0 mg/dL or ≥120 μmol/L) is used to define PLF. This study aimed to validate the peak bilirubin criterion as postoperative risk indicator for 90-day liver-related mortality.

methodsCharacteristics of 956 consecutive patients who underwent partial hepatectomy at the Maastricht University Medical Centre or Royal Free London between 2005 and 2012 were analyzed by uni- and multivariable analyses with odds ratios (OR) and 95% confidence intervals (95%CI).

resultsThirty-five patients (3.7%) met the postoperative peak bilirubin criterion at median day 19 with a median bilirubin level of 183 [121-588] μmol/L. Sensitivity and specificity for liver-related mortality after major hepatectomy were 41.2% and 94.6%, respectively. The positive predictive value was 22.6%. Predictors of liver-related mortality were the peak bilirubin criterion (p < 0.001, OR = 15.9 [95%CI 5.2-48.7]), moderate-severe steatosis and fibrosis (p = 0.013, OR = 8.5 [95%CI 1.6-46.6]), ASA 3-4 (p = 0.047, OR = 3.0 [95%CI 1.0-8.8]) and age (p = 0.044, OR = 1.1 [95%CI 1.0-1.1]).

conclusionThe peak bilirubin criterion has a low sensitivity and positive predictive value for 90-day liver-related mortality after major hepatectomy.

Indexed as

AdultAgedAged, 80 and overBilirubinBiomarkersFemaleHepatectomyHumansLiver FailureLogistic ModelsLondonMaleMiddle AgedMultivariate AnalysisNetherlandsOdds RatioBilirubinBiomarkers

Identifiers

PMID27506991
PMCPMC5061023

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.