Trauma in cirrhotics: Survival and hospital sequelae in patients requiringabdominal exploration

Hepatic cirrhosis significantly increases the mortality and morbidity of el ective surgery; therefore we hypothesized that cirrhosis would adversely im pact outcome after abdominal trauma. We used the trauma registry to identif y 17 patients with cirrhosis who sustained trauma injuries requiring emerge nt exploratory laparotomy, Patients were characterized with respect to age, sex, hospital days, intensive care unit days, and trauma scores. A control group (n = 73) was constructed from the registry by matching age, sex, Inj ury Severity Score (ISS) and Abbreviated Injury score. Mortality rates were compared by Fisher's exact test and age, ISS, Revised Trauma Score 2, and hospital and intensive care unit days were compared by Student's t test. De spite similar ISS between cirrhotic patients and controls, patients with ci rrhosis had a fourfold increase in mortality (mortality odds ratio = 7.2; 9 5% confidence interval = 2.2-24.0). Cirrhotic trauma patients had a complic ation rate of 71 per cent and a mortality of 44 per cent. We conclude that cirrhosis is a major independent risk factor for mortality in trauma patien ts with injuries that require emergent abdominal surgery.