Key result
Liver cirrhosis is linked to ~48% more postoperative complications and higher long-term mortality after cardiac surgery.
Why the study?
The study was conducted to investigate the impact of liver cirrhosis on postoperative complications and long-term outcomes in patients undergoing cardiac surgery.
Does liver cirrhosis increase the risk of postoperative complications and death in patients undergoing cardiac surgery?
Meta-Analysis (n=1,535,129)
Does liver cirrhosis increase the risk of postoperative complications and death in patients undergoing cardiac surgery?
Liver cirrhosis is a significant risk factor for postoperative complications and mortality in patients undergoing cardiac surgery, necessitating careful preoperative assessment.
Patients with cirrhosis warrant heightened perioperative caution in cardiac surgery; confirms elevated risks but leaves optimal strategies open.
The aim of this study was to investigate the impact of liver cirrhosis (LC) on postoperative complications and long-term outcomes in patients who underwent cardiac surgery. Three databases, including PubMed, Embase, and the Cochrane Library, were searched on July 24, 2022. A total of 1,535,129 patients were enrolled in the seven included studies for analysis. According to our analysis, LC was a risk factor for postoperative overall complications (OR = 1.48, 95% CI = 1.21 to 1.81, I2 = 90.35%, P = 0.00 < 0.1). For various complications, more patients developed pulmonary (OR = 1.86, 95% CI = 1.21 to 2.87, I2 = 90.79%, P = 0.00 < 0.1), gastrointestinal (OR = 2.03, 95% CI = 1.32 to 3.11, I2 = 0.00%, P = 0.00 < 0.05), renal (OR = 2.20, 95% CI = 1.41 to 3.45, I2 = 91.60%, P = 0.00 < 0.1), neurological (OR = 1.14, 95% CI = 1.03 to 1.26, I2 = 7.35%, P = 0.01 < 0.05), and infectious (OR = 2.02, 95% CI = 1.17 to 3.50, I2 = 92.37%, P = 0.01 < 0.1) complications after surgery in the LC group. As for cardiovascular (OR = 1.07, 95% CI = 0.85 to 1.35, I2 = 75.23%, P = 0.58 > 0.1) complications, there was no statistical significance between the 2 groups. As for long-term outcomes, we found that in-hospital death (OR = 2.53, 95% CI = 1.86 to 3.20, I2 = 44.58%, P = 0.00 < 0.05) and death (OR = 3.31, 95% CI = 1.54 to 5.07, I2 = 93.81%, P = 0.00 < 0.1) in the LC group were higher than the non-LC group. LC was a risk factor for cardiac surgery. Patients with LC who would undergo cardiac surgery should be fully assessed for the risks of cardiac surgery. Similarly, the surgeon should assess the patient’s liver function before surgery.
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Liu et al. (2023) conducted a meta-analysis in Cardiac disease requiring cardiac surgery (n=1,535,129). Liver cirrhosis vs. No liver cirrhosis was evaluated on Postoperative overall complications (OR 1.48, 95% CI 1.21-1.81, p=0.00). Liver cirrhosis significantly increased the risk of postoperative overall complications (OR 1.48) and long-term mortality in patients undergoing cardiac surgery.
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