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

Nadim Mahmud, Zachary Fricker, Marina Serper, David E. Kaplan, Kenneth D. Rothstein, David S. Goldberg

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1394-1399
Number of pages6
JournalLiver International
Volume39
Issue number8
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • cardiovascular
  • chronic liver disease
  • major abdominal
  • peri-operative mortality
  • risk stratification

ASJC Scopus subject areas

  • Hepatology

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