Prediction of Post-operative Mortality in Patients with HCV-related Cirrhosis Undergoing Non-Hepatic Surgeries
Published: October 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/22478.8620
Khalid Hemida, Reham Ezzat Al Swaff, Sherif Sadek Shabana, Hani Said, Fatma Ali-Eldin
1. Professor, Department of Internal Medicine, Aim Shams University, Cairo, Egypt.
2. Assistant Professor, Department of Internal Medicine, Aim Shams University, Cairo, Egypt.
3. Assistant Professor, Department of Internal Medicine, Aim Shams University, Cairo, Egypt.
4. Assistant Professor, Department of General Surgery, Aim Shams University, Cairo, Egypt.
5. Assistant Professor, Department of Tropical Medicine, Aim Shams University, Cairo, Egypt.
Correspondence Address :
Dr. Reham Ezzat Al Swaff,
Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
E-mail: drrehamalswaff@yahoo.com
Abstract
Introduction: Patients with chronic liver diseases are at great risk for both morbidity and mortality during the post-operative period due to the stress of surgery and the effects of general anaesthesia.
Aim: The main aim of this study was to evaluate the value of Model for End-stage Liver Disease (MELD) score, as compared to Child-Turcotte-Pugh (CTP) score, for prediction of 30- day post-operative mortality in Egyptian patients with liver cirrhosis undergoing non-hepatic surgery under general anaesthesia.
Materials and Methods: A total of 60 patients with Hepatitis C Virus (HCV) - related liver cirrhosis were included in this study. Sensitivity and specificity of MELD and CTP scores were evaluated for the prediction of post-operative mortality. A total of 20 patients who had no clinical, biochemical or radiological evidence of liver disease were included to serve as a control group.
Results: The highest sensitivity and specificity for detection of post-operative mortality was detected at a MELD score of 13.5. CTP score had a sensitivity of 75%, a specificity of 96.4%, and an overall accuracy of 95% for prediction of post-operative mortality. On the other side and at a cut-off value of 13.5, MELD score had a sensitivity of 100%, a specificity of 64.0%, and an overall accuracy of 66.6% for prediction of post-operative mortality in patients with HCV- related liver cirrhosis.
Conclusion: MELD score proved to be more sensitive but less specific than CTP score for prediction of post-operative mortality. CTP and MELD scores may be complementary rather than competitive in predicting post-operative mortality in patients with HCV- related liver cirrhosis
Keywords
Child-turcotte-pugh score, Model for end-stage liver disease score, Post-operative mortality