In-Hospital mortality varies by procedure type among cirrhosis surgery admissions

Area of Science:

• Hepatology
• Surgical Outcomes Research
• Inpatient Health Data Analysis

Background:

• Patients with cirrhosis exhibit elevated peri-operative mortality.
• The influence of specific surgical procedure categories on mortality risk in cirrhotic patients remains unclear.

Purpose of the Study:

• To investigate the association between surgical procedure category and in-hospital mortality in patients with cirrhosis.
• To quantify the adjusted odds of in-hospital mortality across different surgical types for patients with cirrhosis.

Main Methods:

• Retrospective cohort study utilizing the National Inpatient Sample (NIS) database.
• Analysis of cirrhosis surgery admissions between 2012 and 2014.
• Estimation of adjusted odds ratios (OR) for in-hospital mortality by surgical procedure category.

Main Results:

• In-hospital mortality rates significantly varied by surgical procedure category.
• Major abdominal surgeries demonstrated the highest odds of in-hospital mortality (OR 8.27, 95% CI 5.96-11.49) compared to major orthopedic surgeries.
• Major cardiovascular surgeries also showed increased odds of mortality (OR 3.45, 95% CI 2.33-5.09).
• A significant interaction between admission status (elective/non-elective) and surgical procedure category impacted mortality risk (P < 0.001).

Conclusions:

• Surgical procedure type is a critical determinant of in-hospital mortality in patients with cirrhosis.
• Incorporating surgical procedure category into risk prediction models may enhance the accuracy of peri-operative mortality assessment for cirrhotic patients.