Prediction of various forms of postoperative acute liver failure

Abstract

165 patients over 18 years in the period from January 2014 to March 2015 were studied. The aim was to investigate the prognostic significance of known scale assessment of organ dysfunction in respect ofpostoperative hepatic failure. The development of acute liver failure was assessed on the basis of clinical and laboratory data, severity of the condition by scales MELD, Child-Turcotte-Pugh, Maddrey, Schindl, BILE score, SOFA. The paper identified the incidence offorms of acute liver failure (hepatic encephalopathy, hepatic coagulopathy, hepatorenal syndrome, systemic hemodynamic disorder mixed form) in patients after surgery on hepatobiliary system, and the dependence of the probability of their occurrence on the severity of the condition, calculated using a scales in the preoperative period. Calculated sensitivity and specificity in predicting scales investigatedforms of acute liver failure based on ROC-analysis. It was shown that the specialized rating scales have good predictive accuracy in respect of certain forms of hepatic insufficiency (Child-Tur-cotte-Pugh -for hemodynamic options and hepatic coagulopathy, MELD and SOFA scales -for hepatic encephalopathy SCHINDL -for hepatorenal syndrome and mixed forms of hepatic failure). None of the analyzed scales do not possess predictive value with respect to all forms of hepatic failure.