Scientific paperChild-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients
Section snippets
Patients and methods
Under an approved institutional review board protocol, a search of the computerized medical records of a tertiary-care VA Medical Center from September of 1999 to September of 2003 was performed. Cirrhotic patients requiring either emergent (EM) or elective (E) surgery under general anesthesia were identified. Age, demographic data, cause of cirrhosis, and type of surgical procedure were collected. The preoperative CTP and MELD (Table 1) scores were calculated and patient short- (30-day) and
Results
Forty patients with documented cirrhosis underwent elective or emergent surgery requiring general anesthesia. The causes of cirrhosis are shown in Table 2. The mean age was 59 ± 2 years (range = 42–81). Twenty-three (58%) patients were Caucasian, 10 (25%) patients were African American, and 7 (17%) patients were Hispanic. Only 2 patients were women. Twenty-four of the surgeries were elective. The remaining 16 were emergent cases. Table 3 lists the surgeries performed. The overall 30-day
Comments
Many medical tools commonly are used beyond their original intended scope, and often they become the standard of care in their new applications. Such was the case with the CTP score, originally devised by purely empiric observation to predict the outcomes of liver patients undergoing portosystemic surgery in the 1960s and subsequently used by surgeons to assess liver patients before any surgery requiring general anesthesia and by United Network for Organ Sharing as one of the factors in
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