Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery

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.