Background and aim: Chronic liver disease patients often undergo surgery for indications other than liver transplantation ‎and may face increased perioperative risk due to surgical and anesthesia-related complications. The ‎current study's objectives were to assess the risk of surgery in cirrhotic patients and to identify ‎various variables that influence postoperative outcomes‎‎.
Methods: ‎231 participants underwent non-hepatic surgery under general anesthesia categorized into 117 ‎cirrhotic patients and 114 non-cirrhotic (controls). All participants were subjected to complete ‎clinical and laboratory evaluations (pre-operative, and post-operative) with an assessment of ‎postoperative outcomes. For cirrhotic patients, the severity of liver disease was assessed by Child-‎Pugh and MELD scores‎.‎
Results: ‎In cirrhotic patients, hepatic causes are considerably the cause of not having surgery, additionally, ‎the majority of patients who underwent surgery had Child-Pugh scores of A or B (42.7 % and ‎‎44.5%,respectively), whereas only 12.8% had Child-Pugh C. Hepatic complications including HE, ‎decompensation, and SBP were more frequent in patients with CTP grades B and C than those ‎with grade A. Postoperative mortality significantly associated with higher white blood cells ‎‎(WBCs), serum creatinine, and MELD score (p=0.001, 0.049, and 0.002,respectively), and lower ‎serum albumin (p=0.028). AUC for WBCs, serum creatinine, MELD score, and serum albumin ‎was 0.958, 0.759, 0.963, and 0.765 respectively at cut-off >11.5, >1.2, ≤2.3, and >15 respectively‎‎‎‎‎‎‎‎.
Conclusion: Operative complications (hepatic and non-hepatic)are more frequent in patients with CTP grades B ‎and C than those with grade A.  Postoperative mortality significantly associated with higher ‎WBCs, serum creatinine, and MELD score, and lower serum albumin‎‎.