Prediction of Postoperative Mortality in Cirrhotic Patients Undergoing Non-Hepatic Surgeries

Background: Patients with liver disease are at high risk for morbidity and mortality in the postoperative period due to both the stress of surgery and the effects of general anesthesia. The main aim of this study was to evaluate the value of MELD score, as compared to CTP score, for prediction of 30-day postoperative mortality in Egyptian patients with liver cirrhosis undergoing non-hepatic surgery under general anesthesia. Methods: Sixty patients with HCV-related liver cirrhosis were included in this study. Sensitivity and specificity of MELD and CTP scores were evaluated for prediction of postoperative mortality. Twenty 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 postoperative 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 postoperative 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 postoperative mortality in patients with HCV-related liver cirrhosis. Conclusion: MELD score is more sensitive but less specific than CTP score for prediction of postoperative mortality. CTP and MELD scores may be complementary rather than competitive in predicting postoperative mortality in patients with HCV-related liver cirrhosis.