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An assessment of different scoring systems in cirrhotic patients undergoing nontransplant surgery.
MedLine Citation:
PMID:  22521048     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Marlin Wayne Causey; Scott R Steele; Zachary Farris; David S Lyle; Alan L Beitler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  203     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  589-93     Citation Subset:  AIM; IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
Department of Surgery, Madigan Army Medical System, Madigan Health System, Tacoma, WA, USA.
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