Liver cirrhosis and mortality by abdominal surgery. A study of risk factors

To determine the mortality-related factors in cirrhotic patients who underwent nonderivative abdominal surgery.

We retrospectively reviewed the clinical charts of 63 patients (38 men, 25 women) with liver cirrhosis and abdominal surgery. Patients who underwent surgical derivative procedures for portal hypertension and/or hepatic resection for hepatic tumor were excluded. The study population was divided in patients who died (Group 1) and alive patients (Group 2). Thirteen (21%) patients died and the other 50 (79%) had an uneventful course. We compared the clinical and analytical parameters between both groups. Multivariate analysis was performed for the variables with predictive value.

Prothrombin time and the presence of hepatic encefalopathy showed statistical significance in the univariate analysis (p < 0.05 and p < 0.01, respectively). However, in multiple logistic regression analysis serum bilirrubine value was associated with mortality rate (Odds ratio 1.65, 95% CI, 0.97-1.14; p = 0.064). Emergency surgery was required more frequently in patients of group 1 than in those of group 2, but the difference did not achieve statistical significance.

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 factors (albumin, nutrition, infections and urgent surgery) could be due to the small number of patients in our series.