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. 2018 Apr 11:11:1179552217746645.
doi: 10.1177/1179552217746645. eCollection 2018.

The Morbidity and Mortality of Laparoscopic Appendectomy in Patients with Cirrhosis

Yasir Al-Azzawi  1 , Yasir Al-Abboodi  2 , Matthew Fasullo  1 , Tarek Najuib  2
Affiliations

The Morbidity and Mortality of Laparoscopic Appendectomy in Patients with Cirrhosis

Yasir Al-Azzawi et al. Clin Med Insights Gastroenterol. .

Abstract

Introduction: The perioperative mortality is significantly higher in patients with cirrhosis undergoing certain surgical procedures. In this study, we examined the inpatient perioperative mortality and morbidities in cirrhotic people who underwent laparoscopic appendectomy.

Methods: We performed a retrospective analysis using the National Inpatient Sample database for 2010. Inclusion criteria were all race and sex who are 18 years or older. Those who have laparoscopic appendectomy and have a history of liver cirrhosis were assigned to case group. An equal random number of appendectomy-related admissions and those who have no history of liver cirrhosis were selected and placed in the control group. A binary logistic regression statistical test was used to examine the odds ratio for the mortality difference and postoperative complication including pneumonia, urinary tract infection (UTI), surgical site infection, postoperative bleeding. IBM SPSS statistics was used to execute the analysis. A confidence interval of 95% and P value less than .05 were determined to define the statistical significance.

Result: A total of 754 appendectomy-related admissions were identified-376 appendectomy-related admissions and history of cirrhosis and 378 admissions with appendectomy and no history of cirrhosis. Control group was not found to be statistically different from the case group when it comes to age, race, and sex. Of 754, 520 were white (73.5%), 334 (44.3%) were men. The mean age was 43.75 years for the case group and 46.68 years for the control group. Comparing cirrhotic with noncirrhotic group, the mean length of stay was 1.1 vs 1.52 days, inpatient mortality was 2 (0.5%) vs 1 (0.3%) (P = .56), pneumonia 8 (2.1%) vs 3 (0.8%) (P = .142), surgical site infection 3 (0.8%) vs 2 (0.5%) (P = .652), UTI 18 (4.8%) vs 12 (3.2%) (P = .26), and postoperative bleeding 3 (0.8%) vs 2 (0.5%) (P = .65).

Conclusions: Appendectomy-related morbidity and mortality in cirrhotic patients are not different from noncirrhotic patients.

Keywords: Laparoscopy appendectomy; liver cirrhosis; mortality.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34:274–285. - PubMed
    1. Talwalkar JA. Prophylaxis with beta blockers as a performance measure of quality health care in cirrhosis. Gastroenterology. 2006;130:1005–1007. - PubMed
    1. Traussnigg S, Kienbacher C, Halilbasic E, et al. Challenges and management of liver cirrhosis practical issues in the therapy of patients with cirrhosis due to NAFLD and NASH. Dig Dis. 2015;33:598–607. - PubMed
    1. Miele L, Valenza V, La Torre G, et al. Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease. Hepatology. 2009;49:1877–1887. - PubMed
    1. Volynets V, Kuper MA, Strahl S, et al. Nutrition, intestinal permeability, and blood ethanol levels are altered in patients with nonalcoholic fatty liver disease (NAFLD). Dig Dis Sci. 2012;57:1932–1941. - PubMed

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