The significance of underlying cardiac comorbidity on major adverse cardiac events after major liver resection

Tran, Thuy B.; Worhunsky, David J.; Spain, David A.; Dua, Monica M.; Visser, Brendan C.; Norton, Jeffrey A.; Poultsides, George A.

doi:10.1016/j.hpb.2016.06.012

Cited by 14 publications

(9 citation statements)

References 30 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9,17,22 Another important observation of this study was the decreasing proportion of ALPPS patients with cardiovascular disease. Although prevalent cardiovascular disease was not an element of the prestage 1 risk prediction model, 15 the negative impact of this comorbidity on postoperative outcome has been well documented in major liver surgery 23 and might be also a contributing factor of risk adjustment in the present study.…”

Section: -Day Mortalitymentioning

confidence: 68%

Risk Adjustment in ALPPS Is Associated With a Dramatic Decrease in Early Mortality and Morbidity

Linecker¹,

Björnsson

Stavrou³

et al. 2017

Annals of Surgery

127

125

View full text Add to dashboard Cite

show abstract

Section: -Day Mortalitymentioning

confidence: 68%

Risk Adjustment in ALPPS Is Associated With a Dramatic Decrease in Early Mortality and Morbidity

Linecker¹,

Björnsson

Stavrou³

et al. 2017

Annals of Surgery

127

125

View full text Add to dashboard Cite

show abstract

“…In the present study, patients taking statins had a higher prevalence of co‐morbidities such as DM, HTN, IHD and previous stroke. Preoperative factors such as DM, cardiac co‐morbidity and CKD are reported to have a negative influence on the overall outcomes after liver resection. A meta‐analysis documented that DM was associated with a significantly higher risk of overall complications, postoperative infections and liver failure.…”

Section: Discussionmentioning

confidence: 99%

“…A meta‐analysis documented that DM was associated with a significantly higher risk of overall complications, postoperative infections and liver failure. Previous studies have documented that the presence of cardiac co‐morbidities led to a higher risk of 30‐day mortality also in non‐cardiac and major liver surgery. In the present analysis, similar effects were reported with diabetes, IHD and CKD, which all had a negative impact on 90‐day mortality ( Table S1, supporting information).…”

Section: Discussionmentioning

confidence: 99%

Propensity-matched analysis of the influence of perioperative statin therapy on outcomes after liver resection

et al. 2019

View full text Add to dashboard Cite

Background Perioperative use of statins is reported to improve postoperative outcomes after cardiac and non‐cardiovascular surgery. The aim of this study was to investigate the influence of statins on postoperative outcomes including complications of grade IIIa and above, posthepatectomy liver failure (PHLF), and 90‐day mortality rates after liver resection. Methods Patients who underwent hepatectomy between 2013 and 2017 were reviewed to identify statin users and non‐users (controls). Propensity matching was conducted for age, BMI, type of surgery and preoperative co‐morbidities to compare subgroups. Univariable and multivariable analyses were performed for the following outcomes: 90‐day mortality, significant postoperative complications and PHLF. Results Of 890 patients who had liver resection during the study period, 162 (18·2 per cent) were taking perioperative statins. Propensity analysis selected two matched groups, each comprising 154 patients. Overall, 81 patients (9·1 per cent) developed complications of grade IIIa or above, and the 90‐day mortality rate was 3·4 per cent (30 patients), with no statistically significant difference when the groups were compared before and after matching. The rate of PHLF was significantly lower in patients on perioperative statins than in those not taking statins (10·5 versus 17·3 per cent respectively; P = 0·033); similar results were found after propensity matching (10·4 versus 20·8 per cent respectively; P = 0·026). Conclusion The rate of PHLF was significantly lower in patients taking perioperative statins, but there was no statistically significant difference in severe complications and mortality rates.

show abstract

“…Schroeder et al reported that analyzing 587 patients undergoing LR from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database, overall TE after LR were at 3.6% [34] . Another research of 5,227 LRs from ACS-NSQIP database showed that the rate of critical cardiac complications including myocardial infarction and cardiac arrest after LR was at 4.8% in patients with underlying cardiac disease [35] . The present study demonstrated that the incidence of perioperative TE was maintained at 1.5% overall and at 1.9% in patients with continued APT, a relatively low rate compared to the previous report.…”

Section: Discussionmentioning

confidence: 99%

Effect of Perioperative Antiplatelet Management on Thromboembolic Complications after Liver Resection

Fujikawa

2019

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

was assessed by CHADS 2 score, and the rates of TE were compared between the groups. RESULTS: Significantly lower CHADS 2 score of N-APT group was observed compared to those of other groups, although the D-APT and C-APT groups had similar distribution of the scores. Among 398 patients, postoperative TE was found in 6 cases (1.5%). Three cases resulted in in-hospital death and other 3 patients were discharged with moderate to severe sequelae. More TE occurred in the D-APT group (4.2%), whereas only one case in the C-APT group (1.9%) and three cases in the N-APT group (0.7%) were observed (p=0.038). Although having high CHADS 2 scores, patients in C-APT group showed a relatively low rate of postoperative TE events, mainly due to the preventive effect of preoperative aspirin continuation against TE. CONCLUSION: Liver resection should be performed under rigid perioperative antithrombotic management in order to avoid thromboembolic complications. Especially in patients with APT for thrombotic risks, it is suggested that management with continued preoperative single aspirin therapy should be considered regardless of TE risks.

show abstract

The significance of underlying cardiac comorbidity on major adverse cardiac events after major liver resection

Abstract: Background: The risk of postoperative adverse events in patients with underlying cardiac disease

Cited by 14 publications

References 30 publications

Risk Adjustment in ALPPS Is Associated With a Dramatic Decrease in Early Mortality and Morbidity

Risk Adjustment in ALPPS Is Associated With a Dramatic Decrease in Early Mortality and Morbidity

Propensity-matched analysis of the influence of perioperative statin therapy on outcomes after liver resection

Effect of Perioperative Antiplatelet Management on Thromboembolic Complications after Liver Resection

Contact Info

Product

Resources

About