期刊
CIRCULATION JOURNAL
卷 81, 期 4, 页码 476-484出版社
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-16-0849
关键词
Cardiac surgery; Liver cirrhosis; Long-term outcome
资金
- Chang Gung Medical Research project, Chang Gung Memorial Hospital, Linkou, Taiwan [BMRPC19, CMRPG3D1471, CMRPG3D1472, CMRPG3D1473]
Background: Patients with liver cirrhosis (LC) have a higher risk for cardiac surgery, but population-based long-term follow-up studies are lacking. The aim of this study was therefore to validate the long-term outcome of cardiac surgery in patients with LC. Methods and Results: Data were obtained from Taiwan's National Health Insurance Database, 1997-2011. This study included 1,040 LC patients and 1,040 matched controls without LC. The actuarial survival rate at 1, 5 and 10 years in the LC cohort was 68%, 50% and 41%: significantly lower than that of the control cohort at 81%, 68% and 62% at 1, 5 and 10 years after cardiac surgery. Compared with the matched control cohort, the LC group had a higher risk of liver and heart failure readmission (P< 0.001) during the follow-up period. In addition, the LC cohort had a higher risk of liver causes of death than did the control cohort (12.6% vs. 1.2%). In the LC cohort, 51% of deaths were due to hepatocellular carcinoma. And in the LC group, those with valve surgery and advanced cirrhosis had a lower survival rate (P= 0.002, P= 0.001). Conclusions: Even after successful cardiac surgery, long-term outcome is unsatisfactory in LC patients because of the progressive deterioration of liver function.
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