CLDF Title
Home | Contact Us | Bookmark
HBV HE HCC HCV
About CLDF Centers of Educational Expertise  
Live CME Meetings Telewebs Webcasts Slide Library Abstract Library Conference Highlights
 
Back  
 
Reuters Health Information: Nomogram estimates hernia repair riskiness in patients with ascites

Nomogram estimates hernia repair riskiness in patients with ascites

Last Updated: 2014-07-25

By Sharon Nirenberg MD

NEW YORK (Reuters Health) - A new nomogram helps estimate 30-day mortality in patients with ascites who are undergoing umbilical hernia repair, researchers reported.

The nomogram takes into account the Model for End-Stage Liver Disease (MELD) score, albumin, WBC count, and platelet count. (A MELD calculator appears here, on the website of the U.S. Department of Health and Human Services: http://1.usa.gov/1uo2071.)

"Patients with chronic liver disease who require surgery represent a significant clinical challenge to surgeons," writes Dr. Fady Saleh and colleagues at the University Health Network in Toronto, Canada, who developed the nomogram. "Furthermore, up to 20% of patients with decompensated liver disease and ascites will develop an umbilical hernia."

To create a tool to help estimate the mortality risk associated with umbilical hernia repair for a patient with ascites and chronic liver disease, the researchers began by selecting patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).

Eligible patients were 18 years or older, diagnosed with ascites due to liver disease or malignancy postoperatively, and underwent umbilical hernia repair between 2005 and 2011.

Of the 688 patients included in the analysis, 300 (44%) were considered emergent cases and 45 (7%) died within 30 days of undergoing umbilical hernia repair.

Multivariate logistic regression with 30-day mortality as the endpoint found that preoperative MELD score, albumin level, white blood cell count, and platelet count were significant predictors of mortality (p<0.05).

The nomogram appears online in the authors' paper, which was published online June 27 in The American Journal of Surgery. Reuters Health reached out to the authors for comment but did not receive a response by deadline.

Dr. Thomas Schiano, a professor of medicine and liver diseases at Mount Sinai Hospital in New York, told Reuters Health. "I think this nomogram is a helpful guide." He added, "I wouldn't follow it 100% because each patient is different, but I think the lab tests are valid and the results make sense."

SOURCE: http://bit.ly/1mNHnHr

Am J Surg 2014.

 
 
 
 
                 
 
HBV
Webcasts
Slide Library
Abstract Library
 
HE
Live CME Meetings
Webcasts
Slide Library
Abstract Library
 
HCC
Slide Library
Abstract Library
 
 
HCV
Live CME Meetings
Webcasts
Slide Library
Abstract Library
 
CLDF Follow Us
   
 
About CLDF
Mission Statement
Board of Trustees
Board of Advisors
CLDF Supporters
 
Other Resources
Liver News Library
Journal Abstracts
Hep C Link to Care
 
Centers of
Educational Expertise
Regional Map
     
   
  The Chronic Liver Disease Foundation is a non-profit organization with content developed specifically for healthcare professionals.
© Copyright 2012-2014 Chronic Liver Disease Foundation. All rights reserved. This site is maintained as an educational resource for US healthcare providers only.
Use of this Web site is governed by the Chronic Liver Disease Foundation terms of use and privacy statement.