Model for End‐Stage Liver Disease Underestimates Morbidity and Mortality in Patients with Ascites Undergoing Colectomy

Abstract

Ascites predicts an increased risk for postoperative morbidity and mortality for cirrhotic patients undergoing colectomy for all MELD classifications. These findings suggest that the MELD score significantly underestimates postoperative risk as it does not account for ascites.

S3-Leitlinie Divertikelkrankheit/Divertikulitis – Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)

“…Diese steigt mit dem Lebensalter und dem Ausmaß der Komorbidität [270,271]. Auch das Vorliegen von Aszites bei Patienten mit Leberzirrhose hat eine erhöhte perioperative Mortilität [272]. Eine besondere Situation stellt eine Immunsuppression dar, wobei vor allen eine Steroidtherapie die Rate postoperativer Komplikationen erhöht [273][274][275][276].…”

German guideline diverticular disease/diverticulitis

“…This increases with age and the extent of comorbidity 5,6 . In addition, the presence of ascites in patients with liver cirrhosis is associated with increased perioperative mortality 7 . Immunosuppression represents a special situation in which steroid therapy, especially, increases the rate of postoperative complications 8–11 .…”

“… 5 , 6 In addition, the presence of ascites in patients with liver cirrhosis is associated with increased perioperative mortality. 7 Immunosuppression represents a special situation in which steroid therapy, especially, increases the rate of postoperative complications. 8 , 9 , 10 , 11 Similarly, in diverticular haemorrhage, mortality depends to a large extent on comorbidity.…”