Effectiveness of magnesium isoglycyrrhizinate on perioperative hepatic function protection in patients undergoing hepatectomy

Table 1 Demographics and baseline characteristics for the included analysis sets (n = 1711), n (%)

Characteristic	n = 1711
Median age (IQR), years	54.0 (46.0-62.0)
Sex
Male	781 (45.7)
Female	930 (54.4)
Comorbidities
Hypertension	254 (14.9)
Diabetes	142 (8.3)
Hyperlipidemia	29 (1.7)
Coronary heart disease	12 (0.7)
Smoking
Yes	411 (24.0)
No	1300 (76.0)
Drinking
Yes	257 (15.0)
No	1454 (85.0)
Preoperative liver biochemistry, median (IQR)
Alanine aminotransferase, U/L	23.0 (16.0-33.0)
Aspartate aminotransferase, U/L1	22.0 (17.0-29.0)
Total bilirubin, mg/dL2	12.0 (9.1-15.7)
Alkaline phosphatase, U/L3	76.0 (61.0-96.0)
Extent of resection
Major resection	942 (55.1)
Minor resection	769 (44.9)

¹1.3% missing rate.

²0.9% missing rate.

³40.4% missing rate.

Sum may not equal 100% because of rounding. Major liver resection indicates resection of at least half of the liver volume and minor liver resection indicates resection of one fourth or less of the liver volume. Smokers are based on the medical records. IQR: Interquartile range.

Table 2 Cohort balancing characteristics of patients before and after propensity score matching

Perioperative vs postoperative treatment	Before PSM		Statistical volume	P value	After PSM (3:1)		Statistical volume	P value
	Perioperative treatment (n = 532)	Postoperative treatment (n = 110)			Perioperative treatment (n = 330)	Postoperative treatment (n = 110)
Age, years, median (IQR)	54.0 (47.0-62.0)	54.0 (47.0-62.8)	W = 28311.0	0.592	54.0 (47.0-62.0)	54.0 (47.0-62.8)	W = 17514.5	0.582
Male sex	280 (52.6)	70 (63.6)	χ2 = 4.452	0.035	216 (65.5)	70 (63.6)	χ2 = 0.120	0.729
ALT, median (IQR)	24.0 (17.0-33.0)	31.00 (20.3-35.0)	W = 23603.5	0.001	31.0 (20.0-36.0)	31.0 (20.3-35.0)	W = 18114.5	0.976
Extent of resection			χ2 = 0.068	0.794			χ2 = 0.003	0.953
Major resection	351 (66.0)	74 (67.3)			223 (67.6)	74 (67.3)
Minor resection	181 (34.0)	36 (32.7)			107 (32.4)	36 (32.7)
Prophylaxis vs no prophylaxis	Before PSM		Statistical volume	P value	After PSM (1:1)		Statistical volume	P value
	Prophylaxis (n = 876)	No prophylaxis (n = 835)			Prophylaxis (n = 680)	No prophylaxis (n = 680)
Age, years, median (IQR)	53.5 (46.0-62.0)	54.0 (46.0-62.0)	W = 359007.5	0.510	54.0 (46.8-62.0)	53.0 (45.0-62.0)	W = 233831.0	0.716
Male sex	330 (37.7)	451 (54.0)	χ2 = 46.01	< 0.001	319 (46.9)	321 (47.2)	χ2 = 0.012	0.913
ALT, median (IQR)	23.0 (16.0-33.0)	24.00 (16.0-33.0)	W = 356161.5	0.349	23.0 (15.0-33.0)	24.0 (16.0-33.0)	W = 228588.5	0.718
Extent of resection			χ2 = 33.227	< 0.001			χ2 = 1.196	0.274
Major resection	423 (48.3)	519 (62.2)			373 (54.9)	393 (57.8)
Minor resection	453 (51.7)	316 (37.8)			307 (45.2)	287 (42.2)
Treatment with magnesium isoglycyrrhizinate plus other liver protectants vs other liver protectants only	Before PSM		Statistical volume	P value	After PSM (1:3)		Statistical volume	P value
	MgIG plus other liver protectants (n = 110)	Other liver protectants (n = 536)			MgIG plus other liver protectants (n = 110)	Other liver protectants (n = 330)
Age, years, median (IQR)	54.0 (47.0-62.8)	54.0 (47.0-62.0)	W = 28753.0	0.684	54.0 (47.0-62.8)	54.0 (48.0-62.0)	W = 17948.0	0.861
Male sex	70 (63.6)	342 (63.8)	χ2 = 0.001	0.973	70 (63.6)	192 (58.2)	χ2 = 1.019	0.313
ALT, median (IQR)	204.5 (141.3-428.3)	216.5 (116.8-384.0)	W = 28763.5	0.688			W = 17186.0	0.404
Extent of resection			χ2 = 1.264	0.261			χ2 = 0.165	0.685
Major resection	74 (67.3)	389 (72.6)			74 (67.3)	215 (65.2)
Minor resection	36 (32.7)	147 (27.4)			36 (32.7)	115 (34.9)

Sum may not equal 100% because of rounding. Major liver resection indicates resection of at least half of the liver volume and minor liver resection indicates resection of one fourth or less of the liver volume. ALT: Alanine aminotransferase; PSM: Propensity score matching; MgIG: Magnesium isoglycyrrhizinate; IQR: Interquartile range.

Table 3 Analysis of prevalence of hepatic injury post hepatectomy using generalized estimating equation

	Estimates (SE)	Lower limit, upper limit	Z value	P value	OR (95%CI)
Perioperative vs postoperative treatment
POD 1	-0.34 (0.32)	-0.97, 0.29	-1.05	0.294	0.71 (0.38-1.34)
POD 3	-0.75 (0.26)	-1.25, -0.24	-2.88	0.004	0.47 (0.29-0.79)
POD 7	-0.60 (0.28)	-1.14, -0.06	-2.18	0.030	0.55 (0.32-0.94)
Discharge from hospital	0.14 (0.36)	-0.58, 0.85	0.38	0.705	1.15 (0.56-2.34)
Postoperative treatment
POD 3 vs POD 1	-0.77 (0.26)	-1.29, -0.25	-2.92	0.004	0.46 (0.28-0.78)
POD 7 vs POD 1	-3.00 (0.34)	-3.67, -2.35	-8.96	< 0.001	0.05 (0.03-0.10)
Discharge vs POD 1	-4.08 (0.40)	-4.86, -3.29	-10.20	< 0.001	0.02 (0.01-0.04)
Perioperative treatment
POD 3 vs POD 1	-1.18 (0.14)	-1.46, -0.91	-8.41	< 0.001	0.31 (0.23-0.40)
POD 7 vs POD 1	-3.27 (0.20)	-3.66, -2.88	-16.47	< 0.001	0.04 (0.03-0.06)
Discharge vs POD 1	-3.60 (0.21)	-4.01, -3.19	-17.17	< 0.001	0.03 (0.02-0.04)

POD: Postoperative day; CI: Confidence interval; OR: Odds ratio.