The Role and Dynamics of Liver Dysfunction in Patients Undergoing Cardiac Surgery

Study Overview
=================
Brief Summary
-----------------
The aim of the present study is the evaluation of the occurrence and effect of hepatic dysfunction on outcome following cardiac surgery, as well as the monitoring of changes in liver haemodynamics in the early postoperative period.

Detailed Description
-----------------
Prospective, consecutive study of patients undergoing cardiac surgery in Heart and Vascular Center, Semmelweis University, Budapest. Registered data: Anamnestic and demographic data Liver dysfunction prior surgery, etiology of liver dysfunction Perioperative clinical data: laboratory tests, imaging, haemodynamic measures risk prediction score of the American Society of Anesthesiologists(ASA), EUROpean System for Cardiac Operative Risk Evaluation (EuroScore), Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Canadian Cardiovascular Society grading of angina pectoris (CCS) Model for End-Stage Liver Disease (MELD), MELD excluding International Normalised Ratio (INR) (MELD-XI), modified MELD score (modMELD), Child-Pugh The occurrence and etiology pattern of hepatic impairment are going to be evaluated according to age and type of cardiac illness. Correlations between perioperative haemodynamical alterations and structural, functional changes in hepatic status will be investigated. The impact of hepatic impairment on surgical outcome is going to be examined by multivariate regression models.

Official Title
-----------------
The Role and Dynamics of Liver Dysfunction in Patients Undergoing Cardiac Surgery

Conditions
-----------------
Cardiac Surgery, Hepatic Impairment, Heart Failure

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients over 18 years of age admitted for elective cardiac surgical procedures Exclusion Criteria: Not willing to participate. Pregnant women. During active psychiatric hospital care. Patients with defined legal incapability or limited capability. Non-evaluable patient due to insufficient clinical information Patients with a transplanted heart.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The composite of in-hospital death of any cause |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Length of hospital stay |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Length of ICU stay |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evidence of clinically definite postoperative decline in hepatic function |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Need for reoperation due to bleeding or cardiac cause |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Evidence of clinically definite postoperative pulmonary or systemic congestion |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Evidence of clinically definite postoperative low cardiac output syndrome |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Evidence of clinically definite postoperative acute kidney injury and the need for dialysis |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 
| Evidence of clinically definite postoperative impaired coagulation |  | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
MELD score, hemodynamics, liver abnormalities