cliot (version 1.0.0)

liver_decompensation_risk_hcc: Liver Decompensation Risk after Hepatectomy for HCC

Description

Calculates the risk of liver decompensation and liver-related mortality after partial hepatectomy for Hepatocellular Carcinoma (HCC). This hierarchical model stratifies patients into Low, Intermediate, and High risk categories based on the presence of portal hypertension, the extent of resection, and the MELD score.

Usage

liver_decompensation_risk_hcc(portal_hypertension, extent_hepatectomy,
                              meld_score)

Value

A list containing:

Risk_Category

Classification (Low, Intermediate, High).

Est_Liver_Decompensation_Rate

Estimated probability of postoperative liver decompensation.

Est_Liver_Related_Mortality

Estimated probability of liver-related mortality.

Arguments

portal_hypertension

Numeric (0 or 1). Presence of clinically significant portal hypertension (e.g., esophageal varices, splenomegaly with platelets <100,000/uL). (1 = Yes).

extent_hepatectomy

String. Planned extent of liver resection. "minor": Removal of < 3 adjacent segments. "major": Removal of >= 3 adjacent segments.

meld_score

Numeric. Model for End-Stage Liver Disease (MELD) score (or MELD-Na). Threshold for risk stratification is > 9.

References

Citterio D, Facciorusso A, Sposito C, et al. Hierarchic Interaction of Factors Associated With Liver Decompensation After Resection for Hepatocellular Carcinoma. JAMA Surg. 2016;151(10):908-916. doi:10.1001/jamasurg.2016.1121

Examples

# Example 1: High Risk
# Portal HTN, Major Resection
liver_decompensation_risk_hcc(1, "major", 8)

# Example 2: Intermediate Risk
# No Portal HTN, Major Resection
liver_decompensation_risk_hcc(0, "major", 8)

# Example 3: Low Risk
# No Portal HTN, Minor Resection, MELD 8
liver_decompensation_risk_hcc(0, "minor", 8)