Institute Institute of Cardiovascular Diseases Prof Dr George IM Georgescu, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania

WC. Hsieh, PC. Chen, G. Gradinariu, G.Tinica

Prevalence and risk factors of postoperative morbidity after cardiac surgery in patients with chronic viral hepatitis: A RETROSPECTIVE STUDY

introductionIntroduction

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• Current commonly used risk scores (STS-Score, EuroSCORE II ) that evaluate operative mortality and morbidity in cardiac surgery do not account for liver dysfunction

• Our aim is to evaluate the prevalence and risk factors for postoperative morbidity after cardiac surgery in patients with chronic viral hepatitis

• A total of 105 patients in 12 years evaluated with the MELD score

• In subjects who were on anticoagulants, MELD-XI was used

• We checked for postoperative outcomes, including cardiac complications, neurological complications, infection, acute renal failure, and arrhythmia.

MethodMethod

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Result-statistical analysis

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Factors Wald Chi-Square Adjusted OR (95% CI) P value

Valuvar (vs. CAD) 4.4957 3.48 (1.10-11.00) 0.0340

Valuvar+CAD (vs. CAD) 5.0317 12.27 (1.37-109.77) 0.0249

Aortic valve replacement (AVR) (vs.

CABG)

3.9340 0.26 (0.07- 0.98) 0.0473

Bilirubin, (mg/dl) 4.1749 3.63 (1.05-12.49) 0.0410

• Approximately 4 million people in the USA live with chronic hepatitis virus infection: hepatitis B and C virus

• Our results showed that the main postoperative complications for patients with chronic viral hepatitis after cardiac surgery were cardiac complications (54.3%)

• This is consistent with another study, which showed that cardiac complications(31), renal complications(21, 26), and hepatic complications(19) were the postoperative complications for patients with liver disease.

• Most studies showed that liver dysfunction (as reflected by preoperative bilirubin levels) could affect the postoperative morbidity in patients with cirrhosis (8, 11, 19, 22, 26, 27, 31, 33), and this was confirmed by our univariate analysis.

• We found that disease types (valvular, valvular+CAD), aortic valve replacement and bilirubin were the independent risk factors for morbidity.

DiscussionDiscussion

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• Based on our study and univariate analysis, we found that the postoperative complication rate was very high in patients with hepatitis virus infection who underwent cardiac surgery

• Liver dysfunction could be added to available models to predict the hospital morbidity for patients with chronic viral hepatitis who undergo elective cardiac surgery

ConclusionConclusion

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