Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery

Comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices

Dong Hyun Kim, Sung Hoon Kim, Kyung Sik Kim, Woo Jung Lee, Namkyu Kim, Sung Hoon Noh, Choong Bai Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 (≥700mL; 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.

Original languageEnglish
Pages (from-to)832-836
Number of pages5
JournalANZ Journal of Surgery
Volume84
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

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End Stage Liver Disease
Mortality
Liver Cirrhosis
Odds Ratio
General Anesthesia
Medical Records
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kim, Dong Hyun ; Kim, Sung Hoon ; Kim, Kyung Sik ; Lee, Woo Jung ; Kim, Namkyu ; Noh, Sung Hoon ; Kim, Choong Bai. / Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery : Comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices. In: ANZ Journal of Surgery. 2014 ; Vol. 84, No. 11. pp. 832-836.
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title = "Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery: Comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices",
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 (≥700mL; 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.",
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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. / Kim, Dong Hyun; Kim, Sung Hoon; Kim, Kyung Sik; Lee, Woo Jung; Kim, Namkyu; Noh, Sung Hoon; Kim, Choong Bai.

In: ANZ Journal of Surgery, Vol. 84, No. 11, 01.11.2014, p. 832-836.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of mortality in cirrhotic patients undergoing extrahepatic surgery

T2 - Comparison of Child-Turcotte-Pugh and model for end-stage liver disease-based indices

AU - Kim, Dong Hyun

AU - Kim, Sung Hoon

AU - Kim, Kyung Sik

AU - Lee, Woo Jung

AU - Kim, Namkyu

AU - Noh, Sung Hoon

AU - Kim, Choong Bai

PY - 2014/11/1

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N2 - 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 (≥700mL; 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.

AB - 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 (≥700mL; 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.

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