Background Patients with cirrhosis have a reduced life expectancy. Anesthes
ia and surgery have been associated with clinical decompensation in patient
s with cirrhosis.
Methods: The authors retrospectively reviewed the records of all patients w
ith the diagnosis of cirrhosis who underwent any surgical procedure under a
nesthesia at their institution between January 1980 and January 1991 (n = 7
33), Univariate and multivariate analyses were used to identify the variabl
es associated with perioperative complications and short- and longterm surv
ival.
Results: The perioperative mortality rate (within 30 days of surgery) was 1
1.6%. The perioperative complication rate was 30.1%. Postoperative pneumoni
a was the most frequent complication. Multivariate factors that were associ
ated with perioperative complications and mortality included male gender, a
high Child-Pugh score, the presence of ascites, a diagnosis of cirrhosis o
ther than primary biliary cirrhosis (especially cryptogenic cirrhosis), an
elevated creatinine concentration, the diagnosis of chronic obstructive pul
monary disease, preoperative infection, preoperative upper gastrointestinal
bleeding, a high American Society of Anesthesiologists physical status rat
ing, a high surgical severity score, surgery on the respiratory system, and
the presence of intraoperative hypotension.
Conclusion: Risk factors have been identified for patients with cirrhosis w
ho undergo anesthesia and surgery.