The risk of perioperative adverse events in patients with chronic liver disease

Tae Hyung Kim, Soon-Ho Um, Sun Young Yim, Yeon Seok Seo, Hyung Joon Yim, Yoon Tae Jeen, Hong Sik Lee, Hoon-Jai Chun, Chang Duck Kim, Hyonggin Ahn, Yeji Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aims: Chronic liver disease is a common comorbidity in surgery. To assess post-operative morbidity and mortality in relation to progression of chronic liver disease and to identify the risk factors. Methods: Six hundred and nine consecutive patients with chronic liver disease who underwent surgery were classified into two groups: non-cirrhotic (n = 363) and cirrhotic (n = 246). Randomly selected patients without underlying liver disease who underwent surgery were used as control group (n = 148). Results: The occurrence of major post-operative complications was higher in the non-cirrhotic group than in the control group (11.8% vs. 6.1%, P = 0.051); age, type of surgery and serum albumin level were independent predictors for post-operative morbidity. The frequency of significant post-operative liver damage (14.9% vs. 12.2%, P = 0.920) and mortality (0.6% vs. 0.7%, P = 0.871) did not differ between the two groups. The cirrhotic group had markedly higher incidences of post-operative mortality (10.2%), major complications (32.5%) and significant liver damage (43.1%) than the control and non-cirrhotic groups (all P < 0.001). Type of surgery, Child-Pugh score and model for end-stage liver disease score were independently associated with post-operative morbidity and mortality in patients with cirrhosis. Specific data regarding post-operative morbidity and mortality were presented according to progression of liver disease and type of surgery. Conclusion: Non-cirrhotic chronic liver diseases were associated with higher risk of post-operative morbidity, particularly in cases of major surgery, older age and hypoalbuminaemia. Cirrhosis further increased the risk, even death, depending on degree of hepatic decompensation and type of surgery.

Original languageEnglish
Pages (from-to)713-723
Number of pages11
JournalLiver International
Volume35
Issue number3
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Liver Diseases
Chronic Disease
Morbidity
Mortality
Liver
Fibrosis
Hypoalbuminemia
Control Groups
End Stage Liver Disease
Serum Albumin
Comorbidity
Incidence

Keywords

  • Cirrhosis
  • Hepatitis
  • Post-operative complication

ASJC Scopus subject areas

  • Hepatology

Cite this

The risk of perioperative adverse events in patients with chronic liver disease. / Kim, Tae Hyung; Um, Soon-Ho; Yim, Sun Young; Seo, Yeon Seok; Yim, Hyung Joon; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon-Jai; Kim, Chang Duck; Ahn, Hyonggin; Lee, Yeji.

In: Liver International, Vol. 35, No. 3, 01.01.2015, p. 713-723.

Research output: Contribution to journalArticle

@article{ebbc89a7f45a44aabb655e559a00cde2,
title = "The risk of perioperative adverse events in patients with chronic liver disease",
abstract = "Background and Aims: Chronic liver disease is a common comorbidity in surgery. To assess post-operative morbidity and mortality in relation to progression of chronic liver disease and to identify the risk factors. Methods: Six hundred and nine consecutive patients with chronic liver disease who underwent surgery were classified into two groups: non-cirrhotic (n = 363) and cirrhotic (n = 246). Randomly selected patients without underlying liver disease who underwent surgery were used as control group (n = 148). Results: The occurrence of major post-operative complications was higher in the non-cirrhotic group than in the control group (11.8{\%} vs. 6.1{\%}, P = 0.051); age, type of surgery and serum albumin level were independent predictors for post-operative morbidity. The frequency of significant post-operative liver damage (14.9{\%} vs. 12.2{\%}, P = 0.920) and mortality (0.6{\%} vs. 0.7{\%}, P = 0.871) did not differ between the two groups. The cirrhotic group had markedly higher incidences of post-operative mortality (10.2{\%}), major complications (32.5{\%}) and significant liver damage (43.1{\%}) than the control and non-cirrhotic groups (all P < 0.001). Type of surgery, Child-Pugh score and model for end-stage liver disease score were independently associated with post-operative morbidity and mortality in patients with cirrhosis. Specific data regarding post-operative morbidity and mortality were presented according to progression of liver disease and type of surgery. Conclusion: Non-cirrhotic chronic liver diseases were associated with higher risk of post-operative morbidity, particularly in cases of major surgery, older age and hypoalbuminaemia. Cirrhosis further increased the risk, even death, depending on degree of hepatic decompensation and type of surgery.",
keywords = "Cirrhosis, Hepatitis, Post-operative complication",
author = "Kim, {Tae Hyung} and Soon-Ho Um and Yim, {Sun Young} and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Jeen, {Yoon Tae} and Lee, {Hong Sik} and Hoon-Jai Chun and Kim, {Chang Duck} and Hyonggin Ahn and Yeji Lee",
year = "2015",
month = "1",
day = "1",
doi = "10.1111/liv.12529",
language = "English",
volume = "35",
pages = "713--723",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - The risk of perioperative adverse events in patients with chronic liver disease

AU - Kim, Tae Hyung

AU - Um, Soon-Ho

AU - Yim, Sun Young

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Chun, Hoon-Jai

AU - Kim, Chang Duck

AU - Ahn, Hyonggin

AU - Lee, Yeji

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background and Aims: Chronic liver disease is a common comorbidity in surgery. To assess post-operative morbidity and mortality in relation to progression of chronic liver disease and to identify the risk factors. Methods: Six hundred and nine consecutive patients with chronic liver disease who underwent surgery were classified into two groups: non-cirrhotic (n = 363) and cirrhotic (n = 246). Randomly selected patients without underlying liver disease who underwent surgery were used as control group (n = 148). Results: The occurrence of major post-operative complications was higher in the non-cirrhotic group than in the control group (11.8% vs. 6.1%, P = 0.051); age, type of surgery and serum albumin level were independent predictors for post-operative morbidity. The frequency of significant post-operative liver damage (14.9% vs. 12.2%, P = 0.920) and mortality (0.6% vs. 0.7%, P = 0.871) did not differ between the two groups. The cirrhotic group had markedly higher incidences of post-operative mortality (10.2%), major complications (32.5%) and significant liver damage (43.1%) than the control and non-cirrhotic groups (all P < 0.001). Type of surgery, Child-Pugh score and model for end-stage liver disease score were independently associated with post-operative morbidity and mortality in patients with cirrhosis. Specific data regarding post-operative morbidity and mortality were presented according to progression of liver disease and type of surgery. Conclusion: Non-cirrhotic chronic liver diseases were associated with higher risk of post-operative morbidity, particularly in cases of major surgery, older age and hypoalbuminaemia. Cirrhosis further increased the risk, even death, depending on degree of hepatic decompensation and type of surgery.

AB - Background and Aims: Chronic liver disease is a common comorbidity in surgery. To assess post-operative morbidity and mortality in relation to progression of chronic liver disease and to identify the risk factors. Methods: Six hundred and nine consecutive patients with chronic liver disease who underwent surgery were classified into two groups: non-cirrhotic (n = 363) and cirrhotic (n = 246). Randomly selected patients without underlying liver disease who underwent surgery were used as control group (n = 148). Results: The occurrence of major post-operative complications was higher in the non-cirrhotic group than in the control group (11.8% vs. 6.1%, P = 0.051); age, type of surgery and serum albumin level were independent predictors for post-operative morbidity. The frequency of significant post-operative liver damage (14.9% vs. 12.2%, P = 0.920) and mortality (0.6% vs. 0.7%, P = 0.871) did not differ between the two groups. The cirrhotic group had markedly higher incidences of post-operative mortality (10.2%), major complications (32.5%) and significant liver damage (43.1%) than the control and non-cirrhotic groups (all P < 0.001). Type of surgery, Child-Pugh score and model for end-stage liver disease score were independently associated with post-operative morbidity and mortality in patients with cirrhosis. Specific data regarding post-operative morbidity and mortality were presented according to progression of liver disease and type of surgery. Conclusion: Non-cirrhotic chronic liver diseases were associated with higher risk of post-operative morbidity, particularly in cases of major surgery, older age and hypoalbuminaemia. Cirrhosis further increased the risk, even death, depending on degree of hepatic decompensation and type of surgery.

KW - Cirrhosis

KW - Hepatitis

KW - Post-operative complication

UR - http://www.scopus.com/inward/record.url?scp=84922739373&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922739373&partnerID=8YFLogxK

U2 - 10.1111/liv.12529

DO - 10.1111/liv.12529

M3 - Article

C2 - 24620863

AN - SCOPUS:84922739373

VL - 35

SP - 713

EP - 723

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 3

ER -