A retrospective analysis of the impact of diastolic dysfunction on one-year mortality after transjugular intrahepatic porto-systemic shunt, liver transplantation and non-transplant abdominal surgery in patients with cirrhosis

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Φορέας Ελληνική Γαστροεντερολογική Εταιρία
Συλλογή Annals of Gastroenterology A retrospective analysis of the impact
of diastolic dysfunction on one-year mortality after transjugular
intrahepatic porto-systemic shunt, liver transplantation and
non-transplant abdominal surgery in patients with
cirrhosis
Επιμέρους συλλογή Original Articles
ΠεριγραφήBackground The incidence of diastolic dysfunction (DD) approaches 40% in patients with cirrhosis. However, the clinical impact of DD remains a subject of considerable debate. Surgery in patients with cirrhosis is innately hazardous. Diastolic heart failure has been linked to increased mortality after transjugular intrahepatic porto-systemic shunt surgery (TIPSS). To date, none of the commonly accepted preoperative risk assessment models applied to patients with liver disease incorporates DD. We aimed to examine the relationship between DD and postoperative outcomes in patients with cirrhosis undergoing abdominal surgery.Methods Patients with cirrhosis who underwent abdominal surgery between January 2000 and December 2011 were included if they had preoperative echocardiography done within 3 months of surgery. The echocardiographic images were reviewed using flow and tissue Doppler techniques to identify the presence of DD. Outcomes analyzed included one-year mortality and postoperative complications.Results A total of 140 patients were included in the study of which 63 patients (45%) met pre-established criteria for DD. Those with DD were older (P < 0.005) and less likely to have an isolated viral etiology of cirrhosis (P<0.05). The one-year mortality rate was 22.2% (14/63) in patients with DD and 20.8% (16/77) in those without DD (P=0.42). Postoperative complications were not statistically different in the two groups.Conclusion DD is common in patients with cirrhosis. In patients with cirrhosis undergoing TIPS and/or abdominal surgery, the presence of DD does not increase post-procedure complications or one-year mortality.Keywords Diastolic dysfunction, cirrhosis, liver transplantation, postoperative mortality, surgical riskAnn Gastroenterol 2015; 28 (3): 383-388
Δημιουργοί Shounak, Majumder University of Connecticut Health Center Vimal, Rabdiya Hartford Hospital Colin, Swales Hartford Hospital David I, Silverman Hartford Hospital
Συνεργάτης NONE
ΕκδότηςAnnals of Gastroenterology
Ημερομηνία2015-06-15
Μορφότυπος"application/pdf"
Μορφότυποςtext/html
ΠηγήAnnals of Gastroenterology; Volume 28, No 3 (2015); 383
Σχέσηhttp://www.annalsgastro.gr/index.php/annalsgastro/article/do
wnload/1891/10173