Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis

Hoteit, Maarouf; Ghazale, Amaar; Bain, Andrew; Rosenberg, Eli S.; Easley, Kirk A.; Anania, Frank A.; Rutherford, Robin E.

doi:10.3748/wjg.14.1774

Cited by 70 publications

(49 citation statements)

References 25 publications

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“…94 In another study, CTP and MELD scores were similar in predicting outcome after elective surgery but only fairly after urgent surgery in cirrhotics. 98 …”

Section: Comparing Model For End-stage Liver Disease and Child-pugh-tmentioning

confidence: 99%

Model for End-stage Liver Disease

Singal

Kamath

2013

Journal of Clinical and Experimental Hepatology

132

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“…94 In another study, CTP and MELD scores were similar in predicting outcome after elective surgery but only fairly after urgent surgery in cirrhotics. 98 …”

Section: Comparing Model For End-stage Liver Disease and Child-pugh-tmentioning

confidence: 99%

Model for End-stage Liver Disease

Singal

Kamath

2013

Journal of Clinical and Experimental Hepatology

132

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“…Likewise, Mansour et al 18 found similar data, with a mortality of 10%, 30% and 82% for groups Child A, B and C, respectively 18 . Using the MELD criterion (Model for End-stage Liver Disease), other authors have also shown an association between worse post-operative outcome in patients with cirrhosis and worsening of their liver function 5,7,911,15,22,28 .…”

Section: Introductionmentioning

confidence: 99%

Hérnias abdominais e inguinais em pacientes cirróticos: qual é a melhor conduta?

Silva

Andraus

Pinheiro

et al. 2012

ABCD, arq. bras. cir. dig.

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INTRODUÇÃO: Tradicionalmente os procedimentos abdominais eletivos em pacientes cirróticos têm sido amplamente desencorajados graças à elevada morbi-mortalidade consequente às complicações da cirrose, descritas por diversos autores. Outros serviços, em contrapartida, obtiveram resultados distintos, advogando a favor de cirurgia eletiva. MÉTODOS: Uma revisão de artigos utilizando-se a palavras "abdominal wall hernia" e "cirrhotic patients" foi realizada na base de dados PubMed. Dos resultados obtidos, 28 artigos foram considerados para elaboração desta revisão. RESULTADOS: Pôde-se observar que a incidência de hérnias em parede abdominal é relativamente elevada em pacientes cirróticos, sendo que muitas delas têm evolução desfavorável e requerem tratamento cirúrgico específico. Com o advento do sistema de alocação de órgãos baseados no escore de MELD, muitos centros estão repensando suas condutas em situações como esta, dado que muitos dos pacientes em questão encontram-se em lista de espera para transplante hepático. Dessa forma a cirurgia eletiva tem conquistado maior papel no manejo desta condição com intuito de diminuir morbi-mortalidade nesses pacientes. Além disso, a qualidade de vida mostrou-se um importante fator a ser considerado, estando muito prejudicada nesta condição. CONCLUSÃO: Poucos estudos com grandes amostragens foram conduzidos até o momento e não há consenso sobre qual conduta é a mais indicada levando em consideração taxas de morbi-mortalidade.

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“…A retrospective analysis by Teh et al, showed 772 cirrhotics who underwent major gastrointestinal, orthopedic, or cardiovascular surgery, MELD was a strong predictor of mortality at 30 and 90 days while persisting throughout a 20-year follow-up period [119]. MELD score 0-11 correlated with 5-10% 90-day mortality, 12-25 with 25-54% mortality rate, and ≥26 with a 90% postoperative mortality rate [120,121] (Table 2) [122], resulting in a MELD ≥10 having better Sn while MELD ≥25 with better mortality Sp. This was attributed to several factors including more post-necrotic LC and less cardiovascular surgery cases, whereas Teh's study included more patients with alcoholic cirrhosis with a poorer short term survival, and possible ethnic differences medication tolerance [123].…”

Section: Preoperative Evaluation Of Known Cirrhosismentioning

confidence: 99%

Perioperative Risk Assessment and Management of Cirrhotic Patients

AL¹,

Dong²,

Nayi³

2015

J Hepatol Gastroint Dis

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Liver cirrhosis is an important risk factor for morbidity and mortality in any type of surgical procedure. For these patients, a distinct and tailored patient optimization approach prior to surgery is required in order to best risk mitigate towards avoiding decompensation and related complications, especially with the chronicity of this disease. This review is to enhance understanding of surgical risks in these patients in selecting patients for elective surgery, or managing those following emergency surgery.

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Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis

Abstract: The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.

Cited by 70 publications

References 25 publications

Model for End-stage Liver Disease

Model for End-stage Liver Disease

Hérnias abdominais e inguinais em pacientes cirróticos: qual é a melhor conduta?

Perioperative Risk Assessment and Management of Cirrhotic Patients

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