Factors influencing survival after therapeutic shunts. Results of a discriminant function and linear logistic regressions analysis

American Journal of Surgery
J P CelloL W Way

Abstract

Data on 100 consecutive patients undergoing portasystemic shunt at three hospitals of the University of California, San Francisco, were analyzed retrospectively to look for variables portending poor immediate and long-term outcome. As a determinant of early mortality after portacaval shunt, the Child's classification of the patient remains the single most important factor. If the patient is in Child's class C and has a hematocrit of less than 32 percent, he is even less likely to survive 30 days. The malnourished male patient who resumes drinking postoperatively is least likely to survive 1 year. Though short- and long-term mortality did not correlate with type of shunt, the prosthetic interposition mesocaval shunt was associated with an unacceptably high thrombosis rate of 20 percent in our institutions, and represented a technical failure to achieve the goal of preventing further variceal bleeding. No matter what type of shunt was performed, however, the 30 day mortality of Child's class C patients exceeded 50 percent. In the latter patients methods of treatment other than portasystemic shunts should be evaluated.

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Citations

Nov 15, 2002·Nutrition·Manuela MerliOliviero Riggio
Dec 20, 1984·The New England Journal of Medicine·J P CelloD C Heilbron
Apr 11, 1985·The New England Journal of Medicine
Jan 31, 2007·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Manuel A ValerinPeter B Lockhart
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Oct 1, 1986·Scandinavian Journal of Gastroenterology·E SchrumpfA Flatmark
Sep 30, 2019·Clinics in Liver Disease·Melissa Wong, Ronald W Busuttil

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