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. 2019 Aug;39(8):1394-1399.
doi: 10.1111/liv.14156. Epub 2019 Jun 17.

In-Hospital mortality varies by procedure type among cirrhosis surgery admissions

Nadim Mahmud  1 , Zachary Fricker  1 , Marina Serper  1   2 , David E Kaplan  1   2 , Kenneth D Rothstein  1 , David S Goldberg  1   3
Affiliations

In-Hospital mortality varies by procedure type among cirrhosis surgery admissions

Nadim Mahmud et al. Liver Int. 2019 Aug.

Abstract

Background: Patients with cirrhosis have increased peri-operative mortality risk relative to non-cirrhotic patients, however, the impact of surgical procedure category on this risk is poorly understood.

Methods: We performed a retrospective cohort study of cirrhosis surgery admissions using the National Inpatient Sample between 2012 and 2014 to estimate the adjusted odds of in-hospital mortality by surgical procedure category.

Results: In-hospital mortality differed by surgical procedure category. Relative to major orthopedic surgeries, major abdominal surgeries had the highest odds of in-hospital mortality (odds ratio [OR] 8.27, 95% confidence interval [CI] 5.96-11.49), followed by major cardiovascular surgeries (OR 3.45, 95% CI 2.33-5.09). There was also a significant interaction term, whereby elective/non-elective admission status impacted in-hospital mortality risk differently for each surgical procedure category (P < 0.001).

Conclusion: In-hospital mortality varies substantially by surgical procedure type. Accounting for procedure type in models may improve risk prediction for peri-operative mortality in patients with cirrhosis.

Keywords: cardiovascular; chronic liver disease; major abdominal; peri-operative mortality; risk stratification.

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Conflict of interest statement

Conflict of Interest: The authors have no disclosures or conflicts of interest to report.

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