Clinical ascites and emergency procedure as determinants of surgical risk in patients with advanced chronic liver disease
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- dc.contributor.author Canillas, Lidia
- dc.contributor.author Pelegrina Manzano, Amalia
- dc.contributor.author León, Fawaz Wasef
- dc.contributor.author Salis, Aina
- dc.contributor.author Colominas-González, Elena
- dc.contributor.author Caro, Antonia
- dc.contributor.author Sánchez, Juan
- dc.contributor.author Álvarez, Juan C.
- dc.contributor.author Burdío Pinilla, Fernando
- dc.contributor.author Carrión Rodríguez, José Antonio
- dc.date.accessioned 2025-05-08T06:01:10Z
- dc.date.available 2025-05-08T06:01:10Z
- dc.date.issued 2025
- dc.description.abstract Background: Liver function and the presence of portal hypertension, as well as the urgency and type of surgery, are prognostic factors in advanced chronic liver disease (ACLD) patients undergoing extrahepatic major surgeries. Emergent surgery in ACLD patients has 4-10 times higher mortality rates than elective surgery. However, perioperative management improvements have been made in recent years. Methods: This is a retrospective, observational, and unicentric study of 482 patients with ACLD who underwent major surgery from 2010 to 2019. We compared baseline characteristics and postoperative mortality according to the presence of ascites, the emergency, and the surgery period. Results: In total, 140 (29%) patients had ascites, and 191 (39.6%) underwent urgent surgeries. The 90-day mortality was 2.8-fold higher in patients with ascites [HR (95%CI) 2.8 (1.6-5.0); p = 0.001] and 3-fold higher in urgent surgeries [3.0 (1.6 - 5.5); p < 0.001)]. Urgent surgeries in patients with ascites revealed the highest mortality risk [6.3 (2.7-14.8); p < 0.001)], which persisted in current (2015-2019) surgeries [12.8 (2.9-56.5); p = 0.001)]. Portal hypertension was meaningful in patients undergoing abdominal surgery. Conclusions: ascites and emergent surgery increase the mortality risk of patients with ACLD despite the recent perioperative improvements.
- dc.format.mimetype application/pdf
- dc.identifier.citation Canillas L, Pelegrina A, León FW, Salis A, Colominas-González E, Caro A, et al. Clinical ascites and emergency procedure as determinants of surgical risk in patients with advanced chronic liver disease. J Clin Med. 2025 Feb 8;14(4):1077. DOI: 10.3390/jcm14041077
- dc.identifier.doi http://dx.doi.org/10.3390/jcm14041077
- dc.identifier.issn 2077-0383
- dc.identifier.uri http://hdl.handle.net/10230/70324
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof J Clin Med. 2025 Feb 8;14(4):1077
- dc.rights © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Advanced chronic liver disease
- dc.subject.keyword Ascites
- dc.subject.keyword Cirrhosis
- dc.subject.keyword Emergent
- dc.subject.keyword Mortality
- dc.subject.keyword Portal hypertension
- dc.subject.keyword Postoperative risk
- dc.subject.keyword Surgery
- dc.title Clinical ascites and emergency procedure as determinants of surgical risk in patients with advanced chronic liver disease
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion