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There have been limited studies evaluating predictors of PHLF and clinically significant PHLF in non\u2010cirrhotic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study using the National Surgical Quality Improvement Program database (NSQIP) to evaluate 8,093\u00a0non\u2010cirrhotic patients undergoing hepatectomy from 2014 to 2018. Primary endpoints were PHLF and clinically significant PHLF (PHLF grade B or C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among all patients, 4.74% (<jats:italic>n<\/jats:italic>\u2009=\u2009383) developed PHLF and 2.5% clinically significant PHLF (<jats:italic>n<\/jats:italic>\u2009=\u2009203). The overall 30\u2010day mortality was 1.35% (<jats:italic>n<\/jats:italic>\u2009=\u2009109), 11.5% (<jats:italic>n<\/jats:italic>\u2009=\u200944) in patients with PHLF, and 19.2% in those with clinically significant PHLF. Factors associated with PHLF were: metastatic liver disease (OR\u2009=\u20091.84, CI\u2009=\u20091.14\u20132.98), trisectionectomy (OR\u2009=\u20093.71, CI\u2009=\u20092.59\u20135.32), right total lobectomy (OR\u2009=\u20094.17, CI\u2009=\u20093.06\u20135.68), transfusions (OR\u2009=\u20091.99, CI\u2009=\u20091.52\u20132.62), organ\/space SSI (OR\u2009=\u20092.84, CI\u2009=\u20092.02\u20133.98), post\u2010operative pneumonia (OR\u2009=\u20092.43, CI\u2009=\u20091.57\u20133.76), sepsis (OR\u2009=\u20092.27, CI\u2009=\u20091.47\u20133.51), and septic shock (OR\u2009=\u20095.67, CI\u2009=\u20093.43\u20139.36). Patients who developed PHLF or clinically significant PHLF had 2\u2013threefold increased risk of perioperative mortality. Post\u2010hepatectomy renal failure (OR\u2009=\u20098.47, CI\u2009=\u20093.96\u201318.1), older age (OR\u2009=\u20091.04, CI\u2009=\u20091.014\u20131.063), male sex (OR\u2009=\u20091.83, CI\u2009=\u20091.07\u20133.14), sepsis (OR\u2009=\u20092.96, CI\u2009=\u20091.22\u20137.2), and septic shock (OR\u2009=\u20093.92, CI\u2009=\u20091.61\u20139.58) were independently associated with 30\u2010mortality in patients with clinically significant PHLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PHLF in non\u2010cirrhotic patients increased the risk of perioperative mortality and is associated with the extent of hepatectomy and infectious complications. Careful evaluation of the liver remnant, antibiotic prophylaxis, nutritional assessment, and timely management of post\u2010operative infections could decrease major morbidity and mortality following hepatectomy.\n<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06742-3","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T20:02:38Z","timestamp":1665259358000},"page":"3081-3089","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predictors of Liver Failure in Non\u2010Cirrhotic Patients Undergoing Hepatectomy"],"prefix":"10.1002","volume":"46","author":[{"given":"Gabriel","family":"Orozco","sequence":"first","affiliation":[{"name":"Department of Surgery\u2010Transplant Division, College of Medicine University of Kentucky 740 South Limestone, Suite K301 40536\u20100284 Lexington KY 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