Neutrophil-lymphocyte ratio, albumin-alkaline phosphatase ratio, and bilirubin predict outcomes in hepatectomy hepatolithiasis patients

Table 1 Comparison of general data between the groups, n (%)

Items	Good prognosis group (n = 94)	Poor prognosis group (n = 41)	t/χ2	P value
Sex			0.027	0.870
Male	45 (47.87)	19 (46.34)
Female	49 (52.13)	22 (53.66)
Age (years), mean ± SD	44.53 ± 5.27	44.83 ± 5.45	0.298	0.766
BMI (kg/m2), mean ± SD	21.46 ± 2.22	21.74 ± 2.16	0.678	0.499
Course of disease (years), mean ± SD	2.45 ± 0.50	2.39 ± 0.49	0.607	0.545
ASA score grade II	4 (4.26)	7 (17.07)	6.267	0.012
Partial hepatectomy	48 (51.06)	20 (48.78)	0.060	0.807
Anatomical hepatectomy	56 (59.57)	17 (41.46)	3.771	0.005
Location of hepatectomy			0.279	0.870
Bilateral hepatic lobectomy	29 (30.85)	13 (31.71)
Left hepatic lobectomy	31 (32.98)	15 (36.59)
Right hepatic lobectomy	34 (36.17)	13 (31.71)
Intraoperative blood loss (mL), mean ± SD	297.66 ± 26.74	386.93 ± 38.72	15.467	< 0.001
Intraoperative blood infusion	10 (10.64)	13 (31.71)	8.966	0.003
Hepatobiliary surgery history			4.844	0.028
Yes	38 (40.43)	25 (60.98)
No	56 (59.57)	16 (39.02)
Comorbidity
Hypertension	18 (19.15)	9 (21.95)	0.140	0.708
Hyperlipidemia	15 (15.96)	7 (17.07)	0.026	0.872
Diabetes	13 (13.83)	6 (14.63)	0.015	0.902

BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Unconditional logistic regression analysis of factors influencing poor prognosis following hepatectomy

Items	β	SE	Wald	Sig	Exp (β)
ASA score grade II	1.585	0.740	4.580	0.032	4.877 (1.143-20.816)
Anatomical hepatectomy	1.295	0.459	7.967	0.005	3.651 (1.486-8.974)
Intraoperative blood loss	0.095	0.019	24.067	< 0.001	1.099 (1.158-1.142)
Intraoperative blood infusion	2.135	0.588	13.189	< 0.001	8.458 (2.672-26.774)
Hepatobiliary surgery history	1.313	0.458	8.227	0.004	3.717 (1.515-9.115)

ASA: American Society of Anesthesiologists; SE: Standard error.

Table 3 Comparison of biochemical indices of hepatobiliary function between the groups

Groups	NLR	ALB/ALP	TBIL (μmol/L)	IBIL (μmol/L)	AST (U/L)	ALT (U/L)
Good prognosis group (n = 94)	3.45 ± 0.83	0.35 ± 0.07	10.25 ± 2.33	19.84 ± 5.49	10.37 ± 2.46	21.65 ± 5.82
Poor prognosis group (n = 41)	4.65 ± 0.94	0.26 ± 0.05	12.85 ± 2.77	19.33 ± 5.30	9.64 ± 3.27	20.86 ± 5.52
t	7.412	7.504	5.623	0.501	1.428	0.736
P value	< 0.001	< 0.001	< 0.001	0.617	0.156	0.463

NLR: Neutrophil-to-lymphocyte ratio; ALB: Albumin; ALP: Alkaline phosphatase; TBIL: Total bilirubin; IBIL: Indirect bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 4 Predictive value of peripheral blood neutrophil-to-lymphocyte ratio, albumin/alkaline phosphatase ratio, and total bilirubin levels for poor prognosis following hepatectomy

Indicator	Cut-off value	AUC	95%CI	P value	Sensitivity (%)	Specificity (%)
NLR	4.10	0.834	0.756-0.912	< 0.001	75.62	79.81
ALB/ALP	0.31	0.855	0.792-0.918	< 0.001	82.86	76.59
TBIL	12.33	0.769	0.680-0.858	< 0.001	61.00	84.00
Combined detection	-	0.939	0.893-0.985	< 0.001	80.54	93.58

NLR: Neutrophil-to-lymphocyte ratio; ALB: Albumin; ALP: Alkaline phosphatase; TBIL: Total bilirubin; AUC: Area under the curve.