Evidence map›Paper›PMID 37860868›Full record

ArticleAnnals of surgery2025

An APRI+ALBI-Based Multivariable Model as a Preoperative Predictor for Posthepatectomy Liver Failure.

Jonas Santol, Sarang Kim, Lindsey A Gregory, Ruth Baumgartner, Anastasia Murtha-Lemekhova, Emrullah Birgin, Severin Gloor, Eva Braunwarth, Markus Ammann, Johannes Starlinger and 25 more

Open access · hybridAbstract readComparative StudyMulticenter Study
In one paragraph

Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
5.9field-weighted citation impact, top 3% of its field
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

29 citing papers in PubMed, 29 citations in OpenAlex.

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  15. Technological Advances in Pre-Operative Planning.Journal of clinical medicine · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors at 12 institutions in 6 countries.

Jonas SantolDepartment of Surgery, HPB Center, Vienna Health Network, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria.
Sarang KimMedical University of Vienna, Vienna, Austria.
Lindsey A GregoryDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Ruth BaumgartnerDepartment of Oncology, Karolinska University Hospital, Stockholm, Sweden.
Anastasia Murtha-LemekhovaDepartment of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Emrullah BirginDepartment of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Severin GloorDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Eva BraunwarthDepartment of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Markus AmmannDepartment of Surgery, State Hospital Wiener Neustadt, Wiener Neustadt, Austria.
Johannes StarlingerHowto Health GmbH, Berlin, Germany.
David PereyraDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Daphni AmmonDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Marijana NinkovicDepartment of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Anna E KernDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Benedikt RumpfDepartment of Surgery, Hospital Barmherzige Schwestern, Vienna, Austria.
Gregor OrtmayrCenter for Cancer Research, Medical University of Vienna, Vienna, Austria.
Yannic HerrmannMedical University of Vienna, Vienna, Austria.
Yawen DongDepartment of Surgery, HPB Center, Vienna Health Network, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria.
Felix X HuberMedical University of Vienna, Vienna, Austria.
Jeremias WeningerMedical University of Vienna, Vienna, Austria.
Cornelius A ThielsDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Susanne G WarnerDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Rory L SmootDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Mark J TrutyDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Michael L KendrickDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
David M NagorneyDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Sean P ClearyDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Guido BeldiDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Nuh N RahbariDepartment of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Katrin HoffmannDepartment of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Stefan GilgDepartment of HPB surgery, Karolinska University Hospital, Stockholm, Sweden.
Alice AssingerInstitute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria.
Thomas GruenbergerDepartment of Surgery, HPB Center, Vienna Health Network, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria.
Hubert HacklInstitute of Bioinformatics, Biocenter, Medical University of Innsbruck, Innsbruck, Austria.
Patrick StarlingerDepartment of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Medical University of Vienna · ATInnsbruck Medical University · ATMayo Clinic · USMayo Clinic in Arizona · USSigmund Freud University Vienna · ATWinnMed · USUniversity Hospital Heidelberg · DEUniversity Medical Centre Mannheim · DEUniversity of Bern · CHAGO Austria · ATFachhochschule Wiener Neustadt · ATKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

OBJECTIVE AND

backgroundClinically significant posthepatectomy liver failure (PHLF B+C) remains the main cause of mortality after major hepatic resection. This study aimed to establish an aspartate aminotransferase to platelet ratio combined with an albumin-bilirubin grade (APRI+ALBI), based multivariable model (MVM) to predict PHLF and compare its performance to indocyanine green clearance (ICG-R15 or ICG-PDR) and albumin-ICG evaluation (ALICE).

methodsA total of 12,056 patients from the National Surgical Quality Improvement Program database were used to generate a MVM to predict PHLF B+C. The model was determined using stepwise backwards elimination. The performance of the model was tested using receiver operating characteristic curve analysis and validated in an international cohort of 2525 patients. In 620 patients, the APRI+ALBI MVM, trained in the National Surgical Quality Improvement Program cohort, was compared with the MVM's based on other liver function tests (ICG clearance, ALICE) by comparing the areas under the curve (AUC).

resultsA MVM including APRI+ALBI, age, sex, tumor type, and extent of resection was found to predict PHLF B+C with an AUC of 0.77, with comparable performance in the validation cohort (AUC: 0.74). In direct comparison with other MVM's based on more expensive and time-consuming liver function tests (ICG clearance, ALICE), the APRI+ALBI MVM demonstrated equal predictive potential for PHLF B+C. A smartphone application for the calculation of the APRI+ALBI MVM was designed.

conclusionRisk assessment through the APRI+ALBI MVM for PHLF B+C increases preoperative predictive accuracy and represents a universally available and cost-effective risk assessment before hepatectomy, facilitated by a freely available smartphone app.

Indexed as

HepatectomyLiver FailureLiver Function TestsPostoperative ComplicationsPredictive Learning ModelsRisk AssessmentAgedArea Under CurveAspartate AminotransferasesBilirubinDatabases, FactualFemaleHumansMaleMiddle AgedPlatelet CountAspartate AminotransferasesBilirubinSerum Albumin90-day mortalityALICE gradeAPRI+ALBIICG clearanceliver surgery

Identifiers

PMID37860868
PMCPMC11974630
OpenAlexW4387799048

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.