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Cirugía en el paciente cirrótico: características clínicas y complicaciones en una cohorte de pacientes chilenos / Surgical complications in cirrhotic patients: analysis of 102 cases
Gajardo, Abraham IJ; Poniachik, Rafael; Freundlich, Alejandro; Vera, Daniela B; Chesta, Caterina; Rappoport, Jaime; Díaz, Juan Carlos; Saure, Alexandre; Castillo, Jaime; Lembach, Hans; González, Katherine; Navea, César; Poniachik, Jaime.
  • Gajardo, Abraham IJ; Universidad de Chile. Sección de Gastroenterología. Santiago. CL
  • Poniachik, Rafael; Universidad de Chile. Facultad de Medicina. Santiago. CL
  • Freundlich, Alejandro; Universidad de Chile. Facultad de Medicina. Santiago. CL
  • Vera, Daniela B; Universidad de Chile. Sección de Gastroenterología. Santiago. CL
  • Chesta, Caterina; Universidad de Chile. Departamento de Medicina Interna. Santiago. CL
  • Rappoport, Jaime; Universidad de Chile. Hospital Clínico. Departamento de Cirugía. Santiago. CL
  • Díaz, Juan Carlos; Universidad de Chile. Hospital Clínico. Departamento de Cirugía. Santiago. CL
  • Saure, Alexandre; Universidad de Chile. Hospital Clínico. Departamento de Cirugía. Santiago. CL
  • Castillo, Jaime; Universidad de Chile. Hospital Clínico. Departamento de Cirugía. Santiago. CL
  • Lembach, Hans; Universidad de Chile. Hospital Clínico. Departamento de Cirugía. Santiago. CL
  • González, Katherine; Universidad de Chile. Sección de Gastroenterología. Santiago. CL
  • Navea, César; Universidad de Chile. Sección de Gastroenterología. Santiago. CL
  • Poniachik, Jaime; Universidad de Chile. Sección de Gastroenterología. Santiago. CL
Rev. méd. Chile ; 147(9): 1099-1106, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058651
ABSTRACT

Background:

Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications.

Aim:

To describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital. Patients and

Methods:

Review of medical records of 102 cirrhotic patients aged 60 ± 11 years (52% males) who underwent elective or urgency surgery at an university hospital between 2010 and 2016. General, pre-surgical, and post-surgical complications were recorded.

Results:

The main etiologies of cirrhosis were non-alcoholic steatohepatitis (31%), and alcoholic cirrhosis (28%). Child-Pugh scores were A, B and C in 50, 28 and 22% of cases respectively. Median MELD (Model for End-stage Liver Disease) score was 11 (interquartile range 10-15). The surgical procedure was elective in 71% of cases, with predominance of abdominal surgery (86%). The American Society of Anesthesiologists (ASA) score was three or more in 52% of patients. The frequency of any adverse outcome was 62%. The frequency increased along with the severity of cirrhosis and when surgery was urgent. The most common complications were acute renal failure (24%), increased ascites (23%) and encephalopathy (22%). Admission to intensive care unit occurred on 26% of patients, with six hospital deaths.

Conclusions:

In these patients, surgical complications were common, although with low mortality.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: End Stage Liver Disease Type of study: Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Chile/CL

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Full text: Available Index: LILACS (Americas) Main subject: End Stage Liver Disease Type of study: Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Chile/CL