Prognostic value of ascites in patients with liver cirrhosis undergoing cardiac surgery

Abstract Introduction Mild or moderate liver cirrhosis increases the risk of complications after cardiac surgery. Ascites is the most common complication associated with liver cirrhosis. However, the prognostic value of ascites on postoperative morbidity and mortality after cardiac surgery remains u...

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Bibliographic Details
Published in:	Journal of cardiothoracic surgery 2023-10, Vol.18 (1), p.302-302, Article 302
Main Authors:	Cizmic, Amila, Rahmanian, Parwis Baradaran, Gassa, Asmae, Kuhn, Elmar, Mader, Navid, Wahlers, Thorsten
Format:	Article
Language:	eng
Subjects:	Ascites Blood transfusion Cardiac patients Cardiac surgery Care and treatment Complications and side effects Liver cirrhosis Medical research Medicine, Experimental Mortality Postoperative complications Prognosis Surgery
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Summary:	Abstract Introduction Mild or moderate liver cirrhosis increases the risk of complications after cardiac surgery. Ascites is the most common complication associated with liver cirrhosis. However, the prognostic value of ascites on postoperative morbidity and mortality after cardiac surgery remains uninvestigated. Methods A retrospective study included 69 patients with preoperatively diagnosed liver cirrhosis who underwent cardiac surgery between January 2009 and January 2018 at the Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany. The patients were divided into ascites and non-ascites groups based on preoperatively diagnosed ascites. Thirty-day mortality, postoperative complications, length of stay, and blood transfusions were analyzed postoperatively. Results Out of the total of 69 patients, 14 (21%) had preoperatively diagnosed ascites. Ascites group had more postoperative complications such as blood transfusions (packed red blood cells: 78.6% vs. 40.0%, p = 0.010; fresh frozen plasma: 57.1% vs. 29.1%, p = 0.049), acute kidney injury (78.6% vs. 45.5%, p = 0.027), longer ICU stay (8 vs. 3 days, p = 0.044) with prolonged mechanical ventilation (57.1% vs. 23.6%, p = 0.015) and tracheotomy (28.6% vs. 3.6%, p = 0.003). The 30-day mortality rate was significantly higher in the ascites group than in the non-ascites group (35.7% vs. 5.5%, p = 0.002). Conclusion Ascites should be implemented in preoperative risk score assessments in cirrhotic patients undergoing cardiac surgery. Preoperative treatment of ascites could reduce the negative impact of ascites on postoperative complications after cardiac surgery. However, this needs to be thoroughly investigated in prospective randomized clinical trials. Graphical abstract
ISSN:	1749-8090 1749-8090