20 Citations (Scopus)

Abstract

Background Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery. Methods Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87). Conclusion Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators. Increased morbidity and mortality

Original languageEnglish
Pages (from-to)1784-1790
Number of pages7
JournalBritish Journal of Surgery
Volume100
Issue number13
DOIs
Publication statusPublished - Dec 2013

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Liver Cirrhosis
Odds Ratio
Mortality
Fibrosis
Confidence Intervals
Gastrointestinal Hemorrhage
Hepatic Encephalopathy
Jaundice
Acute Kidney Injury
Ascites
Hepatitis
Alcoholism
Intensive Care Units
Sepsis
Anesthesia
Logistic Models
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

@article{3e33593e312f4144aab3d6f325454827,
title = "Postoperative adverse outcomes after non-hepatic surgery in patients with liver cirrhosis",
abstract = "Background Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery. Methods Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87). Conclusion Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators. Increased morbidity and mortality",
author = "Chao-Shun Lin and Shyr-Yi Lin and Chuen-Chau Chang and Wang, {H. H.} and Chien-Chang Liao and Ta-Liang Chen",
year = "2013",
month = "12",
doi = "10.1002/bjs.9312",
language = "English",
volume = "100",
pages = "1784--1790",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "John Wiley and Sons Ltd",
number = "13",

}

TY - JOUR

T1 - Postoperative adverse outcomes after non-hepatic surgery in patients with liver cirrhosis

AU - Lin, Chao-Shun

AU - Lin, Shyr-Yi

AU - Chang, Chuen-Chau

AU - Wang, H. H.

AU - Liao, Chien-Chang

AU - Chen, Ta-Liang

PY - 2013/12

Y1 - 2013/12

N2 - Background Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery. Methods Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87). Conclusion Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators. Increased morbidity and mortality

AB - Background Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery. Methods Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87). Conclusion Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators. Increased morbidity and mortality

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U2 - 10.1002/bjs.9312

DO - 10.1002/bjs.9312

M3 - Article

C2 - 24227365

AN - SCOPUS:84887850848

VL - 100

SP - 1784

EP - 1790

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 13

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