Outcomes of Cardiac Surgery in Patients With Liver Cirrhosis: A Systematic Review and Meta-Analysis.

Authors

• Abhiraj Saxena
• Rob Tatum
• Hui Chen
• Danial Ahmad
• Daler Rahimov
• John Curran
• Tressa Kagarise
• Konstadinos A Plestis
• Keshava Rajagopal
• John W Entwistle
• Vakhtang Tchantchaleishvili

Publication/Presentation Date

4-30-2025

Abstract

Cirrhosis is a progressive form of liver disease associated with significant patient morbidity and mortality. Model for End-Stage Liver Disease (MELD) and Child-Pugh scores are disease severity classification systems that carry predictive value for patients undergoing various procedures. Missing is a granular analysis exploring the association between liver disease severity and clinical outcomes among patients who require cardiac surgery. Our study extracted demographic, periprocedural, and postoperative clinical data for patients with liver cirrhosis undergoing cardiac surgery between 2000 and 2023. Continuous variables were pooled by meta-analysis utilizing a random effects model, and categorical variables were studied using meta-analysis of proportions with logit transformations. The most frequently observed Child-Pugh classification was class A in 60% of patients (95% confidence interval [CI]: 53-67), followed by class B in 33% (95% CI: 27-39) and class C in 4% (95% CI: 2-6). Notably, 30% of patients developed renal failure in the postoperative period (95% CI: 21-39), and overall in-patient mortality occurred in 11% of patients (95% CI: 9-14). There was a significant association between Child-Pugh classification and overall patient survival for 3 years in the postoperative period. No significant relationship was observed between preoperative MELD score and postoperative clinical outcomes. Preoperative Child-Pugh classification is associated with postoperative clinical outcomes among patients undergoing cardiac surgery. More granular data are required to understand the association between MELD scores and postoperative outcomes within the cardiac surgery population.

ISSN

1538-4683

Published In/Presented At

Saxena, A., Tatum, R., Chen, H., Ahmad, D., Rahimov, D., Curran, J., Kagarise, T., Plestis, K. A., Rajagopal, K., Entwistle, J. W., & Tchantchaleishvili, V. (2025). Outcomes of Cardiac Surgery in Patients With Liver Cirrhosis: A Systematic Review and Meta-Analysis. Cardiology in review, 10.1097/CRD.0000000000000917. Advance online publication. https://doi.org/10.1097/CRD.0000000000000917

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40304510

Department(s)

Administration and Leadership

Document Type

Article