1. What is the Cirrhosis Post-operative Risk Calculator?

The Cirrhosis Post-operative Risk Calculator estimates surgical risk for patients with liver cirrhosis using the MELD (Model for End-Stage Liver Disease) score. It helps clinicians assess perioperative mortality risk and make informed surgical decisions.

2. How Does the Calculator Work?

The calculator uses the post-operative risk formula:

Where:

• \( MELD Score \) — Model for End-Stage Liver Disease score (points)
• \( Adjustment \) — Clinical adjustment factor (typically 10)

Explanation: The formula calculates postoperative mortality risk percentage based on the patient's MELD score and an adjustment factor that accounts for surgical type and patient-specific factors.

3. Importance of Post-operative Risk Assessment

Details: Accurate risk assessment is crucial for surgical planning in cirrhotic patients, as they have significantly higher perioperative mortality rates. This helps in patient selection, preoperative optimization, and informed consent.

4. Using the Calculator

Tips: Enter the patient's MELD score (typically 6-40 points) and an appropriate adjustment factor (usually 10 for general surgery). The result represents estimated postoperative mortality risk percentage.

5. Frequently Asked Questions (FAQ)

Q1: What is a MELD score?
A: The MELD score is a numerical scale ranging from 6 to 40 that measures the severity of chronic liver disease based on bilirubin, INR, and creatinine levels.

Q2: What adjustment factor should I use?
A: The standard adjustment factor is 10 for most general surgeries. Lower factors may be used for higher-risk procedures, while higher factors for lower-risk interventions.

Q3: What is considered high surgical risk?
A: Generally, risk >15% is considered high, 5-15% moderate, and <5% low risk. However, this varies by surgical procedure and institutional protocols.

Q4: Are there other factors to consider beyond MELD score?
A: Yes, surgical risk also depends on procedure type, emergency status, comorbidities, portal hypertension severity, and nutritional status.

Q5: Should this calculator replace clinical judgment?
A: No, this is a screening tool that should be used in conjunction with comprehensive clinical assessment and multidisciplinary team evaluation.