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Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study

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Abstract
Background Patients with liver cirrhosis have an increased risk of in-hospital mortality or postoperative complication after surgery. However, large-scale studies on the prognosis of these patients after surgery are lacking. The aim of the study was to investigate the adverse outcomes of patients with liver cirrhosis after surgery over five years.

Methods and findings We used the Health Insurance Review and Assessment Service-National Inpatient Samples (HIRA-NIS) between 2012 and 2016. In-hospital mortality and hospital stay were analyzed using the data. Mortality rates according to the surgical department were also analyzed. Of the 1,662,887 patients who underwent surgery, 16,174 (1.0%) patients had cirrhosis. The in-hospital mortality (8.0% vs. 1.0%) and postoperative complications such as respiratory (6.0% vs. 5.3%) or infections (2.8% vs. 2.4%) was significantly higher in patients with cirrhosis than in those without cirrhosis. In addition, the total hospitalization period and use of the intensive care unit were significantly higher in patients with liver cirrhosis. In propensity score matching analysis, liver cirrhosis increased the risk of adverse outcome significantly [adjusted OR (aOR) 1.67, 95% CI 1.56-1.79, P<0.001], especially in-hospital mortality. In liver cirrhosis group, presence of decompensation or varices showed significantly increased postoperative complication or mortality. Adverse outcomes in patients with cirrhosis was the highest in patients who underwent otorhinolaryngology surgery (aOR 1.86), followed by neurosurgery (aOR 1.72), thoracic and cardiovascular surgery (aOR 1.56), and plastic surgery (aOR 1.36).

Conclusion The adverse outcomes of patients with cirrhosis is significantly high after surgery, despite advances in cirrhosis treatment.
Author(s)
JoHHMinCWKyoungDSParkMAKimSGKimYSChang YJeong SWJang JYLee SHKim HSJun BG김영돈천갑진Yoo JJ
Issued Date
2021
Type
Article
Keyword
cirhosissurgeryoutcomes
DOI
10.1371/journal.pone.0253165
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7249
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_plos_journals_2540711648&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Adverse%20outcomes%20after%20surgeries%20in%20patients%20with%20liver%20cirrhosis%20among%20Korean%20population:%20A%20population-based%20study&amp;offset=0&amp;pcAvailability=true
Publisher
PLOS ONE
Location
미국
Language
영어
ISSN
1932-6203
Citation Volume
16
Citation Number
6
Citation Start Page
0253165
Citation End Page
0253165
Appears in Collections:
Medicine > Medicine
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