Portal de Periódicos da CAPES

Morbidity and Mortality in Cirrhotic Patients Undergoing Anesthesia and Surgery

1999; Lippincott Williams & Wilkins; Volume: 90; Issue: 1 Linguagem: Inglês

10.1097/00000542-199901000-00008

1528-1175

Avishai Ziser, David J. Plevak, Russell H. Wiesner, Jorge Rakela, Kenneth P. Offord, David L. Brown,

Organ Transplantation Techniques and Outcomes

Background Patients with cirrhosis have a reduced life expectancy. Anesthesia and surgery have been associated with clinical decompensation in patients with cirrhosis. Methods The authors retrospectively reviewed the records of all patients with the diagnosis of cirrhosis who underwent any surgical procedure under anesthesia at their institution between January 1980 and January 1991 (n = 733). Univariate and multivariate analyses were used to identify the variables associated with perioperative complications and short- and long-term survival. Results The perioperative mortality rate (within 30 days of surgery) was 11.6%. The perioperative complication rate was 30.1%. Postoperative pneumonia was the most frequent complication. Multivariate factors that were associated with perioperative complications and mortality included male gender, a high Child-Pugh score, the presence of ascites, a diagnosis of cirrhosis other than primary biliary cirrhosis (especially cryptogenic cirrhosis), an elevated creatinine concentration, the diagnosis of chronic obstructive pulmonary disease, preoperative infection, preoperative upper gastrointestinal bleeding, a high American Society of Anesthesiologists physical status rating, 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 who undergo anesthesia and surgery.