Background and Objective: Patients with liver cirrhosis have an increased risk for poor postoperative outcomes after non-hepatic surgery, with liver dysfunction being the most important predictor of poor outcomes. This study aims to determine the association of the albumin-bilirubin (ALBI) grade, aspartate aminotransferase-platelet ratio index (APRI) score, and ALBI-APRI score with postoperative outcomes among cirrhotic patients who have undergone non-hepatic surgery. Methods: This was a retrospective cohort study involving 34 patients. Age, ASA class, urgency of surgery, etiology of liver cirrhosis, preoperative Child-Turcotte-Pugh (CTP) score, Model for End-Stage Liver Disease (MELD) score, ALBI grade, APRI score, and ALBI-APRI score were documented. The outcomes analyzed were postoperative hepatic decompensation (POHD) and in-hospital mortality. Bivariate analysis using the Mann-Whitney U test and Fisher’s exact test was performed. Receiver operating characteristic (ROC) curve analysis was performed to compare the ability of the liver scoring systems to predict the occurrence of study outcomes. Binary logistic regression was performed to measure the odds ratio. Results: The ALBI grade and ALBI-APRI score were significantly associated with both POHD and in-hospital mortality. Both scores were non-inferior to the CTP and MELD scores in predicting study outcomes. Compared to CTP and MELD scores, the ALBI grade was more sensitive but less specific in predicting POHD and as sensitive but more specific in predicting in-hospital mortality. The ALBI-APRI score was less sensitive but more specific than the ALBI grade in predicting both POHD and in-hospital mortality. Conclusions The ALBI grade and ALBI-APRI score were both associated with postoperative hepatic decompensation and in-hospital mortality and were noninferior to the CTP score and MELD score in predicting short-term in-hospital outcomes among cirrhotic patients after non-hepatic surgery.
liver cirrhosis ; in-hospital mortality ; hospital mortality

Humans ; Liver Cirrhosis ; diagnosis ; mortality ; physiopathology ; Logistic Models ; Prognosis

Humans ; Liver ; physiopathology ; Liver Cirrhosis ; mortality ; physiopathology ; Liver Failure ; physiopathology ; Liver Function Tests ; Survival Rate

Liver cirrhosis is commonly associated with bleeding complications due to portal hypertension or coagulopathy. Spontaneous muscle hematoma is a rare but potentially lethal complication of liver cirrhosis. Here we report three cases of spontaneous muscle hematoma diagnosed in patients with alcoholic liver cirrhosis. All three patients died due to recurrent bleeding and liver failure although they had undergone repeated transcatheter arterial embolization of the actively bleeding vessels. We reviewed 14 cases of spontaneous muscle hematoma that were associated with liver cirrhosis, including our cases, and found that the mortality rate was 86%, despite early diagnosis and treatment. Cirrhosis-associated spontaneous muscle hematoma occurred more frequently in patients with alcoholic liver cirrhosis, who accounted for -93% of cases. Thus, spontaneous muscle hematoma should be considered a life-threatening complication in patients with alcoholic liver cirrhosis, and abstinence from alcohol may help to prevent the occurrence of this deadly condition.
Alcoholics* ; Early Diagnosis ; Fibrosis ; Hematoma* ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Liver Failure ; Mortality

Since the hepatocellular carcinoma (HCC) develops in cirrhotic liver and is often multicentric, liver transplantation (LT) seems to be a rational approach for the treatment of HCC. Current selection criteria of LT for HCC are Milan criteria (single nodule < or = 5 cm , or < or = 3 nodules and Carcinoma, Hepatocellular/etiology/*mortality/*surgery ; Humans ; Liver Cirrhosis/*complications ; Liver Neoplasms/etiology/*mortality/*surgery ; *Liver Transplantation ; Salvage Therapy ; Survival Rate

Liver cirrhosis results from chronic liver injury that leads to necroinflammation and fibrosis. The development of liver cirrhosis is significantly associated with increased morbidity and mortality. Liver biopsy has been considered to be the gold standard for the diagnosis of liver cirrhosis, which is characterized by diffuse fibrosis and the development of regenerating nodules. However, liver biopsy is invasive and has some drawbacks, such as sampling error and intraobserver and interobserver variability in the assessment of fibrosis stages. Recently, various non-invasive tests such as serum markers, radiologic tests, and elastography have been investigated to overcome the limitations of liver biopsy. This review will focus on the use of these non-invasive tests for diagnosing liver cirrhosis.
Biomarkers ; Biopsy ; Diagnosis* ; Elasticity Imaging Techniques ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Mortality ; Observer Variation ; Selection Bias

Splenic artery aneurysms, no longer considered rare, occur in 10% of patients with liver cirrhosis and portal hypertension. But, spontaneous rupture of splenic artery aneurysm is a rare condition. Due to a fatal rupture, they are considered dangerous. Rupture is often the first and only symptom. With an increased index of suspicion and early aggressive treatment of asymptomatic splenic artery aneurysms, mortality has drastically decreased. We experienced a case of splenic artery aneurysm rupture associated with liver cirrhosis. A 40-year-old female patient was admitted due to left upper quadrant pain. The patient was diagnosed as splenic artery aneurysm rupture with liver cirrhosis by celiac arteriogram and computed tomography. The patient was treated with splenic artery embolization and splenectomy, but the patient died. In this paper, the case of splenic artery aneurysm rupture associated with liver cirrhosis is reported with review of relevant literatures.
Adult ; Aneurysm* ; Female ; Humans ; Hypertension, Portal ; Liver Cirrhosis* ; Liver* ; Mortality ; Rupture* ; Rupture, Spontaneous ; Splenectomy ; Splenic Artery*

Acquiring a sustained virological response (SVR) in patients with cirrhosis or advanced hepatic fibrosis reduces liver disease-related mortality and the incidence of hepatocellular carcinoma. However, the SVR rate of the current standard of care, which is combination therapy with peg-interferon-alpha and ribavirin, is significantly lower, and treatment-related complications occur more frequently in patients with cirrhosis. Thus, antiviral treatment should be individualized in this population. This review highlights the issues associated with anti-hepatitis C virus treatment in patients with compensated and decompensated cirrhosis.
Carcinoma, Hepatocellular ; Fibrosis ; Hepatitis C* ; Humans ; Incidence ; Liver ; Liver Cirrhosis* ; Mortality ; Ribavirin ; Standard of Care

Endoscopic variceal ligation is an accepted new form of safe treatment for esophageal varices. But, there are a few reports of long-term effect of EVL. We analysed 60 patients to evaluate long-term effect of EVL for esophageal varices. The eradication rate was 96.5%, the mean session for eradication of varices 3.0, the number of bands per person 21.5 and the number of bands per session 7.2, Child-Pugh classes(A: B: C) of patients were improved in 25, not changed in 30, deteriorated in 2 cases by EVL(34:19:4 at postEVL vs 20:19:21 at baseline, p<0.01). No serious treatment-related complication resulted from 167 EVL sessions. The patients were followed for a mean of 10.5 months, during which recurrence rate of varices was 14.5%, rebleeding rate 16.4%, and mortality rate 12,7%. The period from last session to recurrence was 4-19 months(mean 9.6). No late complication of EVL was documented. In conclusion, EVL is a safe and effective for hemostasis and eradication of esophageal varices. Thus it can improve liver function and reduce bleeding-related mortality in patients with liver cirrhosis. But the regular periodic examination for recurrence after an eradication of varices should be required.
Esophageal and Gastric Varices* ; Follow-Up Studies* ; Hemostasis ; Humans ; Ligation* ; Liver ; Liver Cirrhosis ; Mortality ; Recurrence ; Varicose Veins

Endoscopic variceal ligation is an accepted new form of safe treatment for esophageal varices. But, there are a few reports of long-term effect of EVL. We analysed 60 patients to evaluate long-term effect of EVL for esophageal varices. The eradication rate was 96.5%, the mean session for eradication of varices 3.0, the number of bands per person 21.5 and the number of bands per session 7.2, Child-Pugh classes(A: B: C) of patients were improved in 25, not changed in 30, deteriorated in 2 cases by EVL(34:19:4 at postEVL vs 20:19:21 at baseline, p<0.01). No serious treatment-related complication resulted from 167 EVL sessions. The patients were followed for a mean of 10.5 months, during which recurrence rate of varices was 14.5%, rebleeding rate 16.4%, and mortality rate 12,7%. The period from last session to recurrence was 4-19 months(mean 9.6). No late complication of EVL was documented. In conclusion, EVL is a safe and effective for hemostasis and eradication of esophageal varices. Thus it can improve liver function and reduce bleeding-related mortality in patients with liver cirrhosis. But the regular periodic examination for recurrence after an eradication of varices should be required.
Esophageal and Gastric Varices* ; Follow-Up Studies* ; Hemostasis ; Humans ; Ligation* ; Liver ; Liver Cirrhosis ; Mortality ; Recurrence ; Varicose Veins