RISK STRATIFICATION IN CIRRHOTIC PATIENTS UNDERGOING NONHEPATIC SURGERY – LITERATURE REVIEW

Liver cirrhosis is a socially significant chronic disease affecting people of working age that leads to severe, life-threatening complications in the absence of adequate treatment. In the course of the disease, numerous pathophysiological changes develop in the body of the affected patients, leading to permanent reorganization of the functional activity of the cardiovascular, respiratory, excretory systems, as well as deviations in the coagulation and immunological status of patients. The above-listed dysfunctions lead to increased mortality rates and development of complications in the perioperative period in these patients, which makes them unsuitable candidates for surgical treatment. Risk stratification in this patient population and careful selection of suitable surgical candidates require a detailed assessment of the clinical condition of patients and its optimization in order to reduce the initially increased levels of morbidity and mortality. The existing scoring systems that are used with the highest frequency in clinical practice – Child – Pugh – Turcotte and MELD, show similar levels of predictive value in terms of surgical risk. The latter can be adequately defined when they are used simultaneously and implemented in daily clinical practice in patients undergoing emergency or elective non-hepatic surgery.