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Area of Science:

  • Hepatology
  • Gastroenterology
  • Transplant Surgery

Background:

  • Colonoscopies are standard before liver transplantation.
  • Their necessity and risks in decompensated cirrhosis patients are debated.
  • Identifying complication risks is crucial for patient management.

Purpose of the Study:

  • To identify risk factors for post-colonoscopy complications (PCC) in decompensated cirrhosis (DC) patients.
  • To develop a predictive risk score for PCC.
  • To inform clinical decisions regarding pre-transplant colonoscopies.

Main Methods:

  • Retrospective single-center study of DC patients undergoing colonoscopy.
  • Defined primary outcome as complications within 30 days post-procedure.
  • Used logistic regression to identify predictors and create a risk score.

Main Results:

  • MELD-Na score ≥21 (aOR 4.00) and recent infection history (aOR 8.43) were strong predictors of PCC.
  • The predictive model achieved an AUC of 0.78.
  • Observed complication rates were 30.6% and 81.3% for lowest and highest risk quartiles, respectively.

Conclusions:

  • Ascites, spontaneous bacterial peritonitis history, and MELD-Na predict PCC in DC patients.
  • A developed risk score can help predict PCC in this population.
  • External validation of the risk score is recommended.