Evidence map›Paper›PMID 41873572›Full record

ArticleBJS open2025

Acute kidney injury after major hepatectomy: association with postoperative complications and post-hepatectomy liver failure.

Oskar Swartling, Tim Reese, Kristina Hasselgren, Jennie Engstrand, Anna Emilia Kern, Ruth Baumgartner, Poya Ghorbani, Per Sandström, Ernesto Sparrelid, Karl J Oldhafer and 2 more

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

Article in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Oskar SwartlingDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-3783-1567
Tim ReeseDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.
Kristina HasselgrenDepartment of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Jennie EngstrandDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-1123-7022
Anna Emilia KernDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.
Ruth BaumgartnerDepartment of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0001-6994-1421
Poya GhorbaniDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.
Per SandströmDepartment of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Ernesto SparrelidDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.
Karl J OldhaferDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asklepios Hospital Barmbek, Hamburg, Germany.
Bergthor BjörnssonDepartment of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.ORCID 0000-0001-9704-1260
Stefan GilgDivision of Surgery and Oncology, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.

Funding

Cancer Research Funds of Radiumhemmet
6 · The paper itself

Abstract

backgroundPatients undergoing liver resections are at increased risk of acute kidney injury (AKI). The objective of this study was to examine AKI after major hepatectomy and the associated risk of adverse postoperative outcomes, including post-hepatectomy liver failure (PHLF) and mortality.

methodsAll adult patients undergoing major hepatectomy between 2010 and 2021 at three tertiary referral centres in Sweden and Germany were included. Postoperative AKI was based on standardized criteria using serum creatinine and urine output. Logistic regression models were used to explore associations with adverse events.

resultsIn all, 1561 patients were included in the study, of whom 400 (25.6%) developed AKI of any grade. Risk factors for AKI included male sex, higher age, and a low preoperative estimated glomerular filtration rate. Patients with AKI were at increased risk of intensive care unit admission (adjusted odds ratio (aOR) 6.06; 95% confidence interval (c.i.) 2.83 to 12.95), Clavien-Dindo grade ≥ IIIa (aOR 2.08; 95% c.i. 1.61 to 2.67) and PHLF grade B or C (aOR 2.87; 95% c.i. 2.11 to 3.90). Patients with only AKI and patients with both AKI and PHLF grade B or C had an increased risk of 90-day mortality than patients with neither. Postoperative AKI was associated with an increased risk of 90-day mortality even after adjustment for PHLF.

conclusionAKI after major hepatectomy is a common complication and is associated with considerable morbidity and mortality. Postoperative AKI may be both an early risk factor for PHLF after major hepatectomy and independently contribute to 90-day mortality.

Indexed as

Acute Kidney InjuryHepatectomyLiver FailurePostoperative ComplicationsAgedFemaleGermanyGlomerular Filtration RateHumansMaleMiddle AgedRisk FactorsSwedenLiver failureLiver surgeryRenal injury

Identifiers

PMID41873572
PMCPMC13010065

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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.