Preoperative Aspartate Transaminase and Platelet Ratio Index (APRI) as a predictor of postoperative complications after hepatic resection for primary hepatocellular carcinoma

Objective To investigate the predictive value of preoperative Aspartate Transaminase and Platelet Ratio Index (APRI) for postoperative complications in patients with hepatocellular carcinoma after liver resection. Methods The clinical data of 278 patients who underwent hepatic resection for hepatocellular carcinoma from January 2010 to December 2013 were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to determine the cutoff value of APRI. Based on this preoperative APRI, patients were divided into the low-risk group (APRI≤0.37) and the high-risk group (APRI>0.37). Using univariate analysis and multivariate logistic regression, 21 risk factors that might be relevant to postoperative complications were analyzed. Results 159 patients (57.2%) developed postoperative complications. The AUC for APRI in predicting complications was 0.677 (0.615-0.740, P<0.05). At a cutoff value of APRI at 0.37, the sensitivity was 0.616 and the specificity was 0.697. Univariate analysis and logistic regression analysis showed that APRI (P<0.05, OR=2.138), degree of ASA (P<0.05, OR=1.864), prognostic nutritional index (PNI) (P<0.05, OR=0.354) and volume of blood loss during operation (P<0.05, OR=2.836) were independent risk factors of postoperative complications. Conclusions A high APRI (>0.37) was a simple and practicable preoperative index to predict postoperative complications in patients with hepatocellular carcinoma after hepatectomy. Key words: Aspartate transaminase and platelet ratio; Primary hepatocellular carcinoma; Postoperative complication