LIVER-CIRRHOSIS AND MORTALITY BY ABDOMINAL-SURGERY - A STUDY OF RISK-FACTORS

AIM: to determine the mortality-related factors in cirrhotic patients who underwent nonderivative abdominal surgery. PATIENTS AND METHODS: w e retrospectively reviewed the clinical charts of 63 patients (38 men, 25 women) with liver cirrhosis and abdominal surgery. Patients who un derwent surgical derivative procedures for portal hypertension and/or hepatic resection for hepatic tumor were excluded. The study populatio n was divided in patients who died (Group 1) and alive patients (Group 2). Thirteen (21%) patients died and the other 50 (79%) had an uneven tful course. We compared the clinical and analytical parameters betwee n both groups. Multivariate analysis was performed for the variables w ith predictive value. RESULTS: prothrombin time and the presence of he patic encefalopathy showed statistical significance in the univariate analysis (p < 0.05 and p < 0.01, respectively). However, in multiple l ogistic regression analysis serum bilirrubine value was associated wit h mortality rate (Odds ratio 1.65, 95% CI, 0.97-1.14; p = 0.064). Emer gency surgery was required more frequently in patients of group 1 than in those of group 2, but the difference did not achieve statistical s ignificance. CONCLUSIONS: in the present study, the serum bilirrubine value, the prothrombin time and the presence of hepatic encefalopathy were associated with mortality of cirrhotic patients who underwent non -derivative abdominal surgery. The lack of significance of other facto rs (albumin, nutrition, infections and urgent Surgery) could be due to the small number of patients in our series.