PE-155: The Predicting Factors for Mortality after Hip Surgery in Cirrhotic Patients

Aims: Cirrhosis increases the risk of osteoporosis and fracture. However, there are sparse data about outcome of hip fracture in cirrhotic patients. We investigated the predictors for mortality in cirrhotic patients with hip fracture underwent surgery. Methods: A total of 56 cirrhotic patients with hip surgery were retrospectively enrolled between 2006 and 2015. The cause of cirrhosis, Child-Turcotte-Pugh (CTP), model for end stage liver disease (MELD) score, operation record, peri-operative complication, hospital length of stay, in-hospital, 6-month and 1-year mortality after hip fracture were investigated. Results: Six patients (11%) died after hip surgery. Serum platelet, CTP and MELD score at the time of admission were associated with in-hospital mortality. On multivariate analysis, CTP and MELD score were independent factors predicting in-hospital mortality (CTP score: relative risk, 3.219; 95% CI, 1.378 to 7.520; P=0.007, MELD score: relative risk, 3.772; 95% CI, 1.038 to 13.707; P=0.044). The AUROC of MELD score was 0.925 (P=0.001; 95% CI: 0.832-1.00). MELD score ≥ 12.5 was associated with in-hospital mortality. (sensitivity 100%, specificity 76%). Six months and one year after surgery, 18 patients (32.1%) and 25 patients (44.6%) died, respectively. MELD score and the cause of cirrhosis (alcohol) were associated with 6-month and 1-year mortality. On multivariate analysis, MELD score was independent factor predicting 6-month mortality (relative risk, 1.158; 95% CI, 1.009 to 1.329; P=0.037) and the cause of cirrhosis (alcohol) was the only independent factor predicting 1-year mortality (relative risk, 4.222; 95% CI, 1.197 to 14.896; P=0.025). Conclusions: CTP and MELD score were important predictors for in-hospital mortality after hip surgery in cirrhotic patients. Although the hip surgery was performed successfully, long term prognosis was poor especially in alcoholic cirrhotic patients.