Heart Surgery Safe for Compensated Cirrhosis Patients
No increased risk of perioperative complications in patients with Child-Pugh score less than 8
THURSDAY, April 26 (HealthDay News) -- Patients with compensated cirrhosis, defined by a Child-Pugh (CP) score of <8, have no significant increase in postoperative mortality and morbidity following cardiac surgery with cardiopulmonary bypass, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.
To investigate the effect of cirrhosis on mortality and morbidity after cardiac surgery, Carole Macaron, M.D., of the Cleveland Clinic, and colleagues conducted a retrospective study of 54 patients with cirrhosis and 216 matched controls without cirrhosis. All participants underwent cardiac surgery with cardiopulmonary bypass at the same institution between 1992 and 2009. For patients with cirrhosis, the CP class and score were calculated.
The researchers found that, within 90 days of surgery, the mortality rate was 4.6 percent for those with a CP score <8, similar to that observed in control patients without cirrhosis, and significantly lower than the mortality rate for patients with a CP score of ≥8 (70 percent). Hospital stays were significantly shorter for patients with CP scores <8, (15.6 days, versus 26 days for those with CP scores ≥8). Renal failure and the need for dialysis were significantly less likely in those with CP scores <8. These values were similar to those of matched controls.
"Among the patients with liver cirrhosis, patients with CP score <8 might safely undergo cardiac surgery with cardiopulmonary bypass," the authors write. "Our study shows that such patients had similar outcomes in terms of mortality and morbidity compared with their matched controls."