Felipe Maegawa is first author of a significant study of patient frailty's impact on post-hepatectomy outcomes
APRIL 2022
In a study published online by HPB, general and hepatopancreatobiliary surgeon Felipe Maegawa, MD, and co-authors from Texas Tech University Health Sciences Center found that patient frailty can be a strong predictor of 30-day post-hepatectomy complications, and that incorporating frailty into the established predictive models could improve surgical outcomes.
This is the first study to demonstrate how the modified frailty index (mFI) can significantly increase the discriminative ability of Albumin-Bilirubin grade (ALBI), a commonly used model for assessing the severity of liver dysfunction, in predicting post-hepatectomy severe complications and 30-day mortality.
Data was acquired by reviewing the liver-targeted National Surgical Quality Improvement Program (NSQIP) database for 2014–2019, with a total of 24,150 hepatectomies reviewed. The investigators found that worsening frailty was associated with increased incidence of complications, and that incorporating mFI to ALBI score improved the overall prediction of complications and 30-day mortality.
Dr. Maegawa and his co-authors concluded that worsening patient frailty correlated with increased incidence of major complications, 30-day mortality, and postoperative liver failure, and that minimally invasive approaches were associated with decreased risk of major complications for both frail and non-frail patients. They advised that the incorporation of frailty into established predictive models of post-hepatectomy outcomes should be evaluated further in prospective studies.
