Long-Term Outcome of Cardiac Surgery in 1,040 Liver Cirrhosis Patient　- Nationwide Population-Based Cohort Study.
Patients with liver cirrhosis (LC) have a higher risk for cardiac surgery, but population-based long-term follow-up studies are lacking. The aim of this study was therefore to validate the long-term outcome of cardiac surgery in patients with LC.



Data were obtained from Taiwan's National Health Insurance Database, 1997-2011. This study included 1,040 LC patients and 1,040 matched controls without LC. The actuarial survival rate at 1, 5 and 10 years in the LC cohort was 68%, 50% and 41%: significantly lower than that of the control cohort at 81%, 68% and 62% at 1, 5 and 10 years after cardiac surgery. Compared with the matched control cohort, the LC group had a higher risk of liver and heart failure readmission (P<0.001) during the follow-up period. In addition, the LC cohort had a higher risk of liver causes of death than did the control cohort (12.6% vs. 1.2%). In the LC cohort, 51% of deaths were due to hepatocellular carcinoma. And in the LC group, those with valve surgery and advanced cirrhosis had a lower survival rate (P=0.002, P=0.001).



Even after successful cardiac surgery, long-term outcome is unsatisfactory in LC patients because of the progressive deterioration of liver function.
Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University.
An-Hsun
AH
Chou
Tien-Hsing
TH
Chen
Chun-Yu
CY
Chen
Shao-Wei
SW
Chen
Chao-Wei
CW
Lee
Chien-Hung
CH
Liao
Shang-Yu
SY
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D017093:Liver Failure / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome