Postoperative adverse outcomes after non-hepatic surgery in patients with liver cirrhosis

Background: Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery.Methods: Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anesthesia. The adjusted odds ratios (ORs) and 95% confidence intervals (CI) of postoperative adverse events associated with liver cirrhosis were analyzed by multivariable logistic regression.Results: Thirty-day mortality rates among 24282 patients with cirrhosis and 97128 control patients were 1.2% (299 deaths) and 0.7% (635 deaths), respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1.88, 95% CI 1.63-2.16), acute renal failure (OR 1.52, 95% CI 1.34-1.74), septicemia (OR 1.42, 95% CI 1.33-1.51) and intensive care unit admission (OR 1.39, 95% CI 1.33-1.45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2.87, 95% CI 1.55-5.30), alcohol dependence syndrome (OR 3.74, 95% CI 2.64-5.31), jaundice (OR 5.47, 95% CI 3.77-7.93), ascites (OR 5.85, 95% CI 4.62-7.41), gastrointestinal haemorrhage (OR 3.01, 95% CI 2.33-3.90) and hepatic coma (OR 5.11, 95% CI 3.79-6.87).Conclusion: Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators.