Table 3.
Univariate and Multivariate Analysis.
| Univariate Analysis |
Multivariate Analysis |
|||||
|---|---|---|---|---|---|---|
| Risk Factor | Stable liver functiona (total n = 135) n (% of total) | Perioperative deteriorationb or death (total n = 42) n (% of total) | p-value | OR | 95%-CI | p-value |
| Gender | ||||||
| Male | 69 (51.1%) | 23 (54.8%) | 0.73 | |||
| Female | 66 (48.9%) | 19 (48.9%) | ||||
| Age | ||||||
| ≤50 | 69 (51.1%) | 25 (59.5%) | 0.38 | |||
| >50 | 66 (48.9%) | 17 (40.5%) | ||||
| Diabetes | ||||||
| Yes | 26 (19.3%) | 6 (14.3%) | 0.65 | |||
| No | 109 (80.7%) | 36 (85.7%) | ||||
| Smoking | ||||||
| Not smoking | 44 (32.6%) | 22 (52.4%) | 0.02 | |||
| Smoking/Former smoker | 52 (38.5%) | 9 (21.4%) | ||||
| Hemodialysis | ||||||
| Yes | 11 (8.2%) | 10 (23.8%) | 0.01 | |||
| No | 121 (89.6%) | 31 (73.8%) | ||||
| Esophageal varices | ||||||
| Yes | 75 (55.5%) | 27 (64.3%) | 0.37 | |||
| No | 60 (45.5%) | 15 (35.7%) | ||||
| History of Variceal Hemorrhage | ||||||
| Yes | 35 (25.9%) | 14 (33.3%) | 0.43 | |||
| No | 100 (74.1%) | 28 (66.7%) | ||||
| History of SBP | ||||||
| Yes | 27 (20%) | 12 (28.6%) | 0.29 | |||
| No | 108 (80%) | 30 (71.4%) | ||||
| HCC | ||||||
| Yes | 20 (14.8%) | 4 (9.5%) | 0.45 | |||
| No | 115 (85.2%) | 38 (90.5%) | ||||
| Extent | ||||||
| Minor | 77 (57%) | 20 (47.6%) | 0.29 | |||
| Major | 58 (43%) | 22 (52.4%) | ||||
| Urgency | ||||||
| Elective | 113 (83.7%) | 21 (50%) | <0.001 | 1.1 | 0.4–3.4 | 0.805 |
| Emergent | 22 (16.3%) | 21 (50%) | ||||
| Duration of surgery | ||||||
| ≤90 min | 81 (60%) | 32 (76.2%) | 0.04 | |||
| >90 min | 53 (39.3%) | 9 (21.4%) | ||||
| Anesthesia | ||||||
| General | 91 (67.4%) | 35 (83.3%) | 0.05 | |||
| Local/Regional/Conscious sedation | 44 (32.6%) | 7 (16.7%) | ||||
| ASA | ||||||
| 2–3 | 52 (38.5%) | 13 (31%) | 0.4 | |||
| 4 | 6 (4.4%) | 3 (7.1%) | ||||
| Pre-existing Ascites | ||||||
| Yes | 34 (25.2%) | 25 (59.5%) | <0.001 | 5.2 | 2.1–12.9 | <0.001 |
| No | 101 (74.8%) | 17 (40.5%) | ||||
| Pre-existing Hepatic Encephalopathy | ||||||
| Yes | 15 (11.1%) | 12 (28.6%) | 0.01 | |||
| No | 120 (88.9%) | 30 (71.4%) | ||||
| Mechanical Ventilation | ||||||
| Yes | 2 (1.5%) | 8 (19%) | <0.001 | |||
| No | 133 (98.5%) | 34 (81%) | ||||
| Circulatory Support | ||||||
| Yes | 1 (0.7%) | 10 (23.8%) | <0.001 | 12.4 | 1.3–118.4 | 0.029 |
| No | 134 (99.3%) | 32 (76.2%) | ||||
| Transfusion perioperative | ||||||
| Yes | 12 (8.9%) | 16 (38.1%) | <0.001 | 3.8 | 1.2–12.4 | 0.025 |
| No | 123 (91.1%) | 26 (61.9%) | ||||
| Baseline MELD | ||||||
| ≤15 | 74 (54.8%) | 22 (52.4%) | 0.86 | |||
| >15 | 61 (45.2%) | 20 (47.6%) | ||||
| Pre-OP MELD | ||||||
| <15 | 55 (40.7%) | 7 (16.7%) | 0.001 | |||
| ≥15 | 57 (42.2%) | 31 (73.8%) | ||||
| Sodium | ||||||
| ≤135 mmol/l | 36 (26.7%) | 16 (38.1%) | 0.06 | |||
| >135 mmol/l | 86 (63.7%) | 17 (40.5%) | ||||
| Bilirubin | ||||||
| ≤1.2 mg/dl | 39 (28.9%) | 4 (9.5%) | 0.004 | |||
| >1.2 mg/dl | 74 (54.8%) | 35 (83.3%) | ||||
| Creatinin | ||||||
| ≤1.2 mg/dl | 88 (65.2%) | 21 (50%) | 0.08 | |||
| >1.2 mg/dl | 39 (28.9%) | 18 (42.9%) | ||||
| INR | ||||||
| ≤1.2 | 45 (33.3%) | 3 (7.1%) | 0.001 | |||
| >1.2 | 84 (62.2%) | 36 (85.7%) | ||||
| Leukocytes | ||||||
| ≤10 Tsd/μl | 110 (81.5%) | 20 (47.6%) | <0.001 | 4.1 | 1.5–11.2 | 0.006 |
| >10 Tsd/μl | 18 (13.3%) | 20 (47.6%) | ||||
| Hb | ||||||
| <10 g/dl | 46 (34.1%) | 27 (64.3%) | 0.001 | |||
| ≥10 g/dl | 82 (60.7%) | 13 (31%) | ||||
| Thrombocytes | ||||||
| <100 Tsd/μl | 57 (42.2%) | 28 (66.7%) | 0.006 | |||
| ≥100 Tsd/μl | 71 (52.6%) | 12 (28.6%) | ||||
| aPTT | ||||||
| <40 s | 72 (53.3%) | 13 (31%) | 0.02 | |||
| ≥40 s | 54 (40%) | 24 (57.1%) | ||||
| CRP | ||||||
| ≤5 mg/l | 44 (32.6%) | 1 (2.4%) | <0.001 | |||
| >5 mg/l | 76 (56.3%) | 36 (85.7%) | ||||
| AST | ||||||
| <35 U/l | 35 (25.9%) | 7 (16.7%) | 0.28 | |||
| ≥35 U/l | 78 (57.8%) | 28 (66.7%) | ||||
| ALT | ||||||
| <45 U/l | 77 (57%) | 27 (64.3%) | 0.84 | |||
| ≥45 U/l | 35 (25.9%) | 11 (26.2%) | ||||
| Alkaline Phosphatase | ||||||
| ≤130 U/l | 36 (26.7%) | 10 (23.8%) | >0.99 | |||
| >130 U/l | 44 (32.6%) | 13 (31%) | ||||
| Gamma Glutamyltransferase | ||||||
| ≤55 U/l | 30 (22.2%) | 10 (23.8%) | >0.99 | |||
| >55 U/l | 67 (49.6%) | 22 (52.4%) | ||||
| CHE | ||||||
| ≤4.26 kU/l | 46 (34.1%) | 16 (38.1%) | 0.047 | |||
| >4.26 kU/l | 28 (20.7%) | 2 (4.8%) | ||||
| Pre ACLF | ||||||
| 0–1 | 116 (85.9%) | 27 (64.3%) | <0.001 | |||
| 2–3 | 5 (3.7%) | 11 (26.2%) | ||||
ACLF Acute-on-Chronic Liver Failure, ALT Alanine transaminase, aPTT Activated partial thromboplastin time, ASA American Society of Anesthesiologists physical status classification system, AST: Aspartate transaminase, CHE Cholinesterase, CI Confidence Interval, CRP C-reactive Protein, Hb Hemoglobin, HCC Hepatocellular carcinoma, INR International Normalized Ratio, MELD Model for End-stage Liver Disease, OR Odds Ratio, SBP Spontaneous Bacterial Peritonitis.
a
ΔMELD<5.
b
ΔMELD>5.