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Preoperative Liver Stiffness is Associated With Hospital Length of Stay After Cardiac Surgery. J Cardiothorac Vasc Anesth 2022 Nov;36(11):4093-4099

Date

08/02/2022

Pubmed ID

35915004

DOI

10.1053/j.jvca.2022.06.028

Scopus ID

2-s2.0-85139095341 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVES: Risk assessment models for cardiac surgery do not account for the degrees of liver dysfunction. Ultrasound shear-wave elastography measures liver stiffness (LSM), a quantitative measurement related to fibrosis, congestion, and inflammation. The authors hypothesized that preoperative liver stiffness would be associated with hospital length of stay after cardiac surgery.

DESIGN: Prospective observational study.

SETTING: University hospital, single center.

PARTICIPANTS: One hundred five adult patients undergoing nonemergent cardiac surgery.

INTERVENTIONS: Preoperative liver stiffness measured by ultrasound elastography.

MEASUREMENTS AND MAIN RESULTS: The associations were analyzed using linear mixed models, with adjustments for preoperative variables, duration of cardiopulmonary bypass, and type of surgery. Median liver stiffness was 6.4 kPa (range, 4.1-18.6 kPa). The median length of hospital stay was 6 days (range, 3-18 d). Each unit increase in liver stiffness, treated as a continuous variable, was associated with an increase of 0.32 ± 0.10 days in the hospital (p = 0.002). When treated as a categorical variable (<6 kPa, 6-9.4 kPa, and ≥9.5 kPa), LSM ≥9.5 kPa v LSM <6 kPa was associated strongly with an increase in hospital length of stay of 3.25 ± 0.87 days (p = 0.0003).

CONCLUSIONS: A preoperative LSM ≥9.5 kPa was associated with a significantly longer postoperative hospital length of stay. This association appeared independent of preoperative comorbidities commonly associated with coronary disease. Preoperative liver stiffness is a novel risk metric that is associated with the postoperative hospital length of stay after cardiac surgery.

Author List

Suffredini G, Slowey C, Sun J, Gao WD, Choi CDW, Aziz H, Kilic A, Schena S, Lawton J, Hamilton JP, Dodd-O JM

Author

Stefano Schena MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Cardiac Surgical Procedures
Hospitals
Humans
Length of Stay
Liver
Liver Cirrhosis