Postoperative Risk of Hepatic Decompensation after Orthopedic Surgery in Patients with Cirrhosis

作     者：Eric M.Nyberg Michael Batech T.Craig Cheetham Jose R.Pio Susan L.Caparosa Mary Alice Chocas Anshuman Singh 

作者机构：Department of OrthopaedicsKaiser PermanenteSan DiegoUSA Department of Research & EvaluationKaiser PermanentePasadenaUSA Department of OrthopaedicsKaiser PermanenteSan DiegoUSA Department of OrthopaedicsUniversity of California at San DiegoSan DiegoUSA 

出 版 物：《Journal of Clinical and Translational Hepatology》 (临床与转化肝病杂志（英文版）)

年 卷 期：2016年第4卷第2期

页      面：83-89页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Kaiser Permanente Southern California Regional Research Committee 

主　　题：Cirrhosis Orthopedic surgery 

摘      要：Background and Aims:Previous studies have shown increased hepatic decompensation in patients with cirrhosis undergoing ***,there are little data available in cirrhotics undergoing orthopedic surgery compared to cirrhotics who did not undergo *** aim of this study was to examine the demographics,comorbid conditions,and clinical factors associated with hepatic decompensation within 90 days in cirrhotics who underwent orthopedic ***:This is a retrospective matched cohort *** criteria were cirrhosis diagnosis,age 18 years,≥ 6 months continuous health plan membership,and a procedure code for orthopedic *** to five cirrhotic controls without orthopedic surgery were matched on age,gender,and cirrhosis diagnosis *** abstraction was performed for demographics,socioeconomics,clinical,and decompensation *** review was performed for *** analysis estimated relative risk of ***:Eight hundred fifty-three orthopedic surgery cases in cirrhotics were matched with 4,263 cirrhotic *** the cases and matched controls,the mean age was 60.5 years,and 52.2% were *** 90 days after surgery,cases had more decompensation compared to matched controls (12.8% vs 4.9%).Using multivariable analysis,orthopedic surgery,a 0.5 g/dL decrease in serum albumin,and a 1-unit increase in Charlson Comorbidity Index were associated with a significantincrease in decompensation within 90 days of ***,chronic obstructive pulmonary disease,and chronic kidney disease were seen with increased frequency in cases *** ***:Cirrhotics who underwent orthopedic surgery had a significant increase in hepatic decompensation within 90 days of surgery compared to matched *** incremental decrease in serum albumin and an incremental increase in the Charlson Comorbidity Index were significantly associated with hepatic decompensation after surgery.