Risk of Surgery in Patients with Liver Disease

Yachimski, Patrick

doi:10.1007/978-3-642-04519-6_50

Cited by 1 publication

(2 citation statements)

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“…1,6 There are several reasons why liver cirrhosis predisposes to poor outcomes: anemia, coagulopathy, portal hypertension, impaired detoxification, and increased susceptibility to infection; all of which are important factors in trauma survival. 3,7 Liver failure from cirrhosis has a wide range of severity, from asymptomatic, to debilitating leading quickly to death. MELD score and Child-Turcotte-Pugh (CTP) classification are two common ways to grade liver cirrhosis, and both have been found to be associated with mortality.…”

Section: Introductionmentioning

confidence: 99%

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Predicting Outcomes in Trauma Patients With Cirrhosis Using Model for End-Stage Liver Disease Score: A Retrospective Study

Natkha

Southerland

Almekdash

et al. 2022

The American Surgeon™

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Background Liver cirrhosis is associated with increased mortality in trauma victims. We stratified the impact of cirrhosis on trauma mortality by Model for End-stage Liver Disease (MELD) score. Methods Trauma center database was accessed for patients with established diagnosis of cirrhosis presenting 2014 - 2018, matched to control patients without cirrhosis in a 2:1 ratio by age, sex, and TRISS. Primary outcome was mortality, secondary outcomes were length of stay, intensive care unit days, and ventilator dependent days. Results Cirrhosis was present in 182 (1.5%) trauma patients. Mortality difference between 12 (7%) deaths in cirrhosis cohort versus 14 (4%) in control was not statistically significant (p = 0.38). No difference was found in secondary outcomes. Categorization of cirrhosis severity by MELD score range (MELD 6-7, 8-10, 11-14, 15-20, 21-30) showed a 1.9 fold increase in the odds of mortality for every increase in MELD score category (OR = 1.91, p = 0.03, 95% CI = 1.08 – 3.37). Conclusion Mortality effects of cirrhosis in trauma patients can be estimated using MELD score.

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