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Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery: comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices

Authors
 Dong Hyun Kim  ;  Sung Hoon Kim  ;  Kyung Sik Kim  ;  Woo Jung Lee  ;  Nam Kyu Kim  ;  Sung Hoon Noh  ;  Choong Bai Kim 
Citation
 ANZ Journal of Surgery, Vol.84(11) : 832-836, 2014 
Journal Title
 ANZ Journal of Surgery 
ISSN
 1445-1433 
Issue Date
2014
Abstract
BACKGROUND: Underlying liver cirrhosis is associated with high morbidity and mortality after surgery. Previous studies have reported conflicting results about the value of Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) scores as predictors of post-operative mortality. This study was designed to compare the capacities of CTP, MELD and MELD-based indices in predicting mortality for patients with liver cirrhosis who underwent elective extrahepatic surgery. METHODS: The medical records of 79 patients with liver cirrhosis who underwent elective extrahepatic surgery under general anaesthesia from December 2000 to December 2009 were reviewed retrospectively. RESULTS: The median follow-up period was 21 months, and the mortality rate was 24.1% (n = 19). Among the 19 mortalities, nine (11.4%) occurred while the patient was hospitalized after surgery. Intraoperative transfusion amount (≥700 mL; odds ratio 6.294, P = 0.004) and the integrated MELD score (≥34; odds ratio 6.654, P = 0.007) were significantly correlated with post-operative mortality. CTP score (hazard ratio 1.575, P = 0.012) was significantly correlated with overall mortality. CONCLUSIONS: Integrated MELD may be a more accurate predictor of operative mortality in cirrhotic patients undergoing extrahepatic surgery than CTP and other MELD-Na based indices. However, overall mortality may be reflected more accurately by CTP score. Further large-scale study will be needed to validate this result.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/ans.12198/abstract
DOI
10.1111/ans.12198
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Choong Bai(김충배)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138350
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