An assessment of different scoring systems in cirrhotic patients undergoing nontransplant surgery

Marlin Wayne Causey, Scott R. Steele, Zachary Farris, David S. Lyle, Alan L. Beitler

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

BACKGROUND: Determining surgical risk in cirrhotic patients is difficult and multiple scoring systems have sought to quantify this risk. The purpose of our study was to assess the impact of Childs-Turcotte-Pugh (CTP), Model of End-Stage Liver Disease (MELD), and MELD-Sodium (MELD-Na) scores on postoperative morbidity and mortality for cirrhotic patients undergoing nontransplant surgery. METHODS: We performed a single-center retrospective review of all cirrhotic patients who underwent nontransplant surgery under general anesthesia over a 6-year period of time to analyze outcomes using the 3 scoring systems. RESULTS: Sixty-four cirrhotic patients (mean age, 57 y; 62 men) underwent nontransplant surgery under general anesthesia. A CTP score of <7.5 was associated with an 8.3-fold increased risk of 30-day morbidity, a MELD score of <14.5 was associated with a 5.4-fold increased risk of 3-month mortality, and a MELD-Na score <14.5 was associated with a 4.5-fold increased risk of 1-year mortality. Emergent surgery, the presence of ascites, and low serum sodium level were associated significantly with morbidity and 1-year mortality. CONCLUSIONS: The major strengths of the 3 scoring systems are for CTP in estimating 30-day morbidity, MELD for estimating 3-month mortality, and MELD-Na for estimating 1-year mortality.

Original languageEnglish (US)
Pages (from-to)589-593
Number of pages5
JournalAmerican Journal of Surgery
Volume203
Issue number5
DOIs
StatePublished - May 1 2012

Keywords

  • Childs-Turcotte-Pugh
  • Cirrhosis
  • MELD
  • MELD-Na
  • Surgery

ASJC Scopus subject areas

  • Surgery

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