Ahmed, M., Elfauomy, M., ElZohry, H., Ammar, K., Elfauomy, M., Helal, A. (2023). Risk Stratification in Cirrhotic Patients with Emergent Surgery. The Egyptian Journal of Hospital Medicine, 90(2), 2406-2412. doi: 10.21608/ejhm.2023.286018
Mohamed Meligy Ahmed; Marwa Elfauomy; Hassan Ahmed ElZohry; Khaled Ammar; Mohmamed Elfauomy; Abdelaleem Helal. "Risk Stratification in Cirrhotic Patients with Emergent Surgery". The Egyptian Journal of Hospital Medicine, 90, 2, 2023, 2406-2412. doi: 10.21608/ejhm.2023.286018
Ahmed, M., Elfauomy, M., ElZohry, H., Ammar, K., Elfauomy, M., Helal, A. (2023). 'Risk Stratification in Cirrhotic Patients with Emergent Surgery', The Egyptian Journal of Hospital Medicine, 90(2), pp. 2406-2412. doi: 10.21608/ejhm.2023.286018
Ahmed, M., Elfauomy, M., ElZohry, H., Ammar, K., Elfauomy, M., Helal, A. Risk Stratification in Cirrhotic Patients with Emergent Surgery. The Egyptian Journal of Hospital Medicine, 2023; 90(2): 2406-2412. doi: 10.21608/ejhm.2023.286018
Risk Stratification in Cirrhotic Patients with Emergent Surgery
Background: Patients with liver disease have a unique pathophysiology that results in the need for a specialized evaluation before undergoing any surgical procedure. The objective of the present study was to assess different risk scores for high-risk cirrhotic patients. Patients and methods: We evaluated 115 cirrhotic patients in an Emergency Department, of the National Liver Institute, Menoufia University, using MELD, PALBI, ALBI, MELD Na scores. The studied cases had different presentations; 79 patients with strangulated umbilical hernia with bowel loops, 29 patients with intestinal ischemia from acute mesenteric vascular occlusion managed by surgical explorations, and 7 patients with secondary peritonitis from neglected spontaneous bacterial peritonitis.All participants signedan informed written consent. Results: MELD had a best cut off point 9.5, PALBI best cut off point -2.5, ALBI best cut off point -1.5, and MELD Na best cut off point 287.5. Sensitivities of MELD, PALBI, ALBI and MELD Na were 81.2%, 67%, 50%, and 44%, respectively. While specificities of MELD, PALBI, ALBI and MELD Na were 70%, 44.1%, 85.3%, and 77%, respectively. Conclusion: MELD, PALBI, and ALBI could be used in risk stratification in cirrhotic patients with emergent surgery.
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