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Meld score liver transplant mayo7/25/2023 ![]() 2 However, other authors have reported the Child classification and Pugh score failed to predict postoperative 30-day mortality. This influence was demonstrated across a range of different surgical procedures and was significant by both univariate and multivariate analyses. 4 Additionally, the CP score has been shown to have significant prognostic influence on postoperative complications and mortality. The CP class has been shown to be valuable in determining prognosis in cirrhotic patients undergoing medical management. The variables used in the calculation of the CP class were not the result of systematic analysis but rather emerged from clinical experience. Historically, the severity of cirrhotic liver disease has been calculated using the Child-Pugh (CP) class. 3 Risk stratification for these patients is difficult and often precludes surgical intervention. Despite this, as many as 10% of cirrhotic patients will require surgical procedures, often when their liver disease is poorly compensated. 2 This documentation has contributed to the concern many surgeons express when confronted with individuals with known liver disease who may need surgical procedures. The morbidity and mortality of cirrhotic patients undergoing a variety of surgical procedures has been well documented. The preprocedure use of diuretics and operative use of anesthetics further strains the liver and associated pathways. 1 This morbidity likely is related to the disruption that liver disease exerts on blood flow as well as on biochemical and metabolic pathways. Previous reports have demonstrated increased perioperative morbidity and mortality in patients with cirrhosis. Chronic liver failure affects multiple organ systems and results in a shortened life expectancy.
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