Liver cirrhosis and mortality by abdominal surgery. A study of risk factors
Carbó, J.; García-Samaniego, J.; Castellano, G.; Iñiguez, A.; Solís-Herruzo, J.A.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 90(2): 105-112
1998
ISSN/ISBN: 1130-0108 PMID: 9580437 Document Number: 485363
Aim: to determine the mortality-related factors in cirrhotic patients who underwent nonderivative abdominal surgery. PATIENTS AND METHODS: we retrospectively reviewed the clinical charts of 63 patients (38 men, 25 women) with liver cirrhosis and abdominal surgery. Patients who underwent surgical derivative procedures for portal hypertension and/or hepatic resection for hepatic tumor were excluded. The study population was divided in patients who died (Group 1) and alive patients (Group 2). Thirteen (21%) patients died and the other 50 (79%) had an uneventful course. We compared the clinical and analytical parameters between both groups. Multivariate analysis was performed for the variables with predictive value. RESULTS: prothrombin time and the presence of hepatic encephalopathy showed statistical significance in the univariate analysis (p < 0.05 and p < 0.01, respectively). However, in multiple logistic regression analysis serum bilirrubine value was associated with mortality rate (Odds ratio 1.65, 95% CI, 0.97-1.14; p = 0.064). Emergency surgery was required more frequently in patients of group 1 than in those of group 2, but the difference did not achieve statistical significance. CONCLUSIONS: in the present study, the serum bilirrubine value, the prothrombin time and the presence of hepatic encephalopathy were associated with mortality of cirrhotic patients who underwent non-derivative abdominal surgery. The lack of significance of other factors (albumin, nutrition, infections and urgent surgery) could be due to the small number of patients in our series.