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

<h4>Background</h4>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 out...

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Autores principales:	Hyun Ho Jo, Changwook Min, Dae-Sung Kyoung, Min-Ae Park, Sang Gyune Kim, Young Seok Kim, Young Chang, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Baek Gyu Jun, Young Don Kim, Gab Jin Cheon, Jeong-Ju Yoo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8dbc34b708564df68eba844103d82d40
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spelling	oai:doaj.org-article:8dbc34b708564df68eba844103d82d402021-12-02T20:10:41ZAdverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.1932-620310.1371/journal.pone.0253165https://doaj.org/article/8dbc34b708564df68eba844103d82d402021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253165https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusion</h4>The adverse outcomes of patients with cirrhosis is significantly high after surgery, despite advances in cirrhosis treatment.Hyun Ho JoChangwook MinDae-Sung KyoungMin-Ae ParkSang Gyune KimYoung Seok KimYoung ChangSoung Won JeongJae Young JangSae Hwan LeeHong Soo KimBaek Gyu JunYoung Don KimGab Jin CheonJeong-Ju YooPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253165 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyun Ho Jo Changwook Min Dae-Sung Kyoung Min-Ae Park Sang Gyune Kim Young Seok Kim Young Chang Soung Won Jeong Jae Young Jang Sae Hwan Lee Hong Soo Kim Baek Gyu Jun Young Don Kim Gab Jin Cheon Jeong-Ju Yoo Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
description	<h4>Background</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusion</h4>The adverse outcomes of patients with cirrhosis is significantly high after surgery, despite advances in cirrhosis treatment.
format	article
author	Hyun Ho Jo Changwook Min Dae-Sung Kyoung Min-Ae Park Sang Gyune Kim Young Seok Kim Young Chang Soung Won Jeong Jae Young Jang Sae Hwan Lee Hong Soo Kim Baek Gyu Jun Young Don Kim Gab Jin Cheon Jeong-Ju Yoo
author_facet	Hyun Ho Jo Changwook Min Dae-Sung Kyoung Min-Ae Park Sang Gyune Kim Young Seok Kim Young Chang Soung Won Jeong Jae Young Jang Sae Hwan Lee Hong Soo Kim Baek Gyu Jun Young Don Kim Gab Jin Cheon Jeong-Ju Yoo
author_sort	Hyun Ho Jo
title	Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
title_short	Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
title_full	Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
title_fullStr	Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
title_full_unstemmed	Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.
title_sort	adverse outcomes after surgeries in patients with liver cirrhosis among korean population: a population-based study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8dbc34b708564df68eba844103d82d40
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Adverse outcomes after surgeries in patients with liver cirrhosis among Korean population: A population-based study.

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