Using noninvasive clinical parameters to predict mortality and morbidity after cardiac interventions in patients with cirrhosis: A systematic review.

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Saudi Journal of Gastroenterology Pub Date : 2024-01-01 Epub Date: 2023-11-18 DOI:10.4103/sjg.sjg_263_23

Christo Mathew, Ankur Patel, George Cholankeril, Avegail Flores, Ruben Hernaez

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引用次数: 0

Abstract

Background: Cardiovascular disease commonly affects advanced liver disease patients. They undergo cardiac interventions to improve cardiac outcomes. Cirrhosis increases complication risk, including bleeding, renal and respiratory failure, and further decompensation, including death, posing a clinical dilemma to proceduralists. Predicting outcomes is crucial in managing patients with cirrhosis. Our aim was to systematically review clinical parameters to assess the mortality and complication risk in patients with cirrhosis undergoing cardiac interventions.

Methods: We searched cirrhosis and cardiovascular intervention terminology in PubMed and Excerpta Medica Database (EMBASE) from inception to January 8, 2023. We included studies reporting clinical scores (e.g. Model for End-stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT), cardiovascular interventions, mortality, and morbidity outcomes). We independently abstracted data from eligible studies and performed qualitative summaries.

Results: Eight studies met the inclusion criteria. Procedures included tricuspid valve surgery, catheterization-related procedures, aortic valve replacement (AVR), pericardiectomy, and left ventricular assist device (LVAD) placement. MELD primarily predicted mortality (n = 4), followed by CPT (n = 2). Mortality is significantly increased for MELD > 15 after tricuspid valve surgery. Albumin, creatinine, and MELD were significantly associated with increased mortality after transcatheter AVR (TAVR), although specific values lacked stratification. CPT was significantly associated with increased mortality after cardiac catheterization or pericardiectomy. In LVAD placement, increasing MELD increased the unadjusted odds for perioperative mortality.

Conclusions: Our systematic review showed that clinical parameters predict mortality and morbidity risk in patients with cirrhosis undergoing cardiac procedures.

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使用无创临床参数预测肝硬化患者心脏干预后的死亡率和发病率:一项系统综述。

背景:心血管疾病常见于晚期肝病患者。他们接受心脏干预以改善心脏预后。肝硬化增加了并发症的风险，包括出血、肾脏和呼吸衰竭，以及进一步的代偿失代偿，包括死亡，这给程序医生带来了临床困境。预测预后对于治疗肝硬化患者至关重要。我们的目的是系统地回顾临床参数，以评估肝硬化患者接受心脏干预的死亡率和并发症风险。方法:我们在PubMed和医学摘录数据库(EMBASE)中检索从成立到2023年1月8日的肝硬化和心血管干预术语。我们纳入了报告临床评分的研究(例如终末期肝病模型(MELD)、Child-Pugh-Turcotte (CPT)、心血管干预、死亡率和发病率结果)。我们独立地从符合条件的研究中提取数据，并进行定性总结。结果:8项研究符合纳入标准。手术包括三尖瓣手术、导管相关手术、主动脉瓣置换术(AVR)、心包切除术和左心室辅助装置(LVAD)置入术。MELD主要预测死亡率(n = 4)，其次是CPT (n = 2)。三尖瓣手术后MELD患者的死亡率显著增加。白蛋白、肌酐和MELD与经导管AVR (TAVR)后死亡率增加显著相关，尽管具体值缺乏分层。CPT与心导管置入术或心包切除术后死亡率增加显著相关。在LVAD放置中，MELD的增加增加了围手术期死亡率的未调整几率。结论:我们的系统综述显示，临床参数可以预测接受心脏手术的肝硬化患者的死亡率和发病率风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Saudi Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.40

自引率

3.70%

发文量

审稿时长

28 weeks

期刊介绍： The Saudi Journal of Gastroenterology (SJG) is an open access peer-reviewed publication. Authors are invited to submit articles in the field of gastroenterology, hepatology and nutrition, with a wide spectrum of coverage including basic science, epidemiology, diagnostics, therapeutics, public health, and standards of health care in relation to the concerned specialty. Review articles are usually by invitation. However review articles of current interest and a high standard of scientific value could also be considered for publication.