TELLAPRIALBI

TELLAPRIALBI predicts risk of postoperative liver dysfunction and 30-day mortality after hepatic resection by combining the Aspartate aminotransferase/Platelet Ratio Index (APRI) and the Albumin-Bilirubin Grade (ALBI) into a prognostic score.

Key Features:

• Integration of Prognostic Indices: Combines APRI and ALBI scores into a single prognostic metric associated with postoperative grade C liver dysfunction, 30-day mortality, and liver dysfunction-associated 30-day mortality.
• Data-driven Development: Developed using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) dataset with preoperative blood values and detailed 30-day postoperative outcomes for 12,055 patients who underwent hepatic resection between 2014 and 2017.
• External Validation: Predictive performance was validated in a separate cohort of 3,517 patients from 2017.
• Multivariable Analysis: Associations between the combined APRI/ALBI score and postoperative mortality were confirmed using multivariable analysis.
• Subgroup Analyses: Disease-specific risk models were derived from subgroup analyses of different tumor types to provide tailored risk estimates.

Scientific Applications:

• Preoperative Risk Stratification: Predicts likelihood of postoperative liver dysfunction and 30-day mortality to support risk assessment before hepatic resection.
• Surgical Decision Support: Informs surgical decision-making, patient selection, and preoperative planning through evidence-based prognostic estimates.

Methodology:

Model development used ACS NSQIP data (12,055 patients, 2014–2017) incorporating preoperative blood values and 30-day outcomes, combined APRI and ALBI scores into a prognostic metric, validated in a separate cohort of 3,517 patients from 2017, and assessed associations via multivariable analysis with subgroup analyses to derive disease-specific risk models.