ArticleAnnals of gastroenterology2021
Trends in surgical volume and in-hospital mortality among United States cirrhosis hospitalizations.
Article in Annals of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Trends in surgical volume and mortality by surgery type among patients with cirrhosis: A Veterans Affairs study.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- Pre-Operative Assessment of Patients with Cirrhosis for Extrahepatic Surgery.Current hepatology reports · 2025Review
- Preoperative Hepatology and Primary Care Visits Improve Postoperative Outcomes in Patients With Cirrhosis Undergoing Surgery.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Surgical risk stratification in patients with cirrhosis.Hepatology international · 2024Review
- Operating under pressure: Is there a place for preoperative TIPS?JHEP reports : innovation in hepatology · 2024Article
- Preoperative risk evaluation and optimization for patients with liver disease.Gastroenterology report · 2024Review
- Modeling Optimal Clinical Thresholds for Elective Abdominal Hernia Repair in Patients With Cirrhosis.JAMA network open · 2022Article
- Risk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Article
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2 authors.
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Abstract
backgroundIn the aging population of patients with cirrhosis in the United States, there is a potentially increased need for surgical procedures. However, individuals with cirrhosis have increased perioperative risk relative to patients without cirrhosis. We sought to quantify temporal trends in cirrhosis surgical procedures and in-hospital mortality in relation to surgical procedure type, elective admission status and compensated vs. decompensated status.
methodsWe performed a retrospective cohort study of cirrhosis hospitalizations between 2005 and 2014 using the National Inpatient Sample. Surgical procedures of interest included cholecystectomy, hernia repair, and major abdominal, orthopedic and cardiovascular surgery. We plotted trends in volume and in-hospital mortality by procedure type, and used linear regression to test the significance of trends.
resultsWhile the number of cirrhosis hospitalizations increased over time, the number of surgeries per 1000 admissions decreased (b=-1.454, P<0.001). When stratified by elective admission status, elective major orthopedic surgeries significantly increased over time (b=177.9; P<0.001). In-hospital mortality rates for most surgeries were significantly higher in the non-elective vs. elective setting (each P<0.001). In patients with compensated cirrhosis, there was a significant increase in the number of orthopedic (b=272.4; P<0.001) and hernia repair surgeries over time (b=191.1; P<0.001). Overall, there was significantly greater in-hospital mortality among patients with decompensated cirrhosis (each P<0.05). Q. Please mention the exact P-value unless <0.001.
conclusionsDespite an increasing number of cirrhosis hospitalizations, the decreasing relative number of cirrhosis surgeries may indicate progressive surgical risk aversion. Future cirrhosis surgical risk scores should consider surgical procedure type, elective/non-elective status, and decompensation status.
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