{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:15:35Z","timestamp":1777446935473,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mortality and complications are not well defined nationally for emergency general surgery (EGS) patients presenting with underlying all-cause liver disease (LD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>We analyzed the 2012-2014 National Inpatient Sample for adults (aged \u2265 18 years) with a primary EGS diagnosis. Underlying LD included International Classification of Diseases, Ninth Revision, Clinical Modification codes for alcoholic and viral hepatitis, malignancy, congenital etiologies, and cirrhosis. The primary outcome was mortality; secondary outcomes included complications, operative intervention, and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 6.8 million EGS patients, 358 766 (5.3%) had underlying LD. 59.1% had cirrhosis, 6.7% had portal hypertension, and 13.7% had ascites. Compared with other EGS patients, EGS-LD patients had higher mean costs ($12 847 vs $10 234, P &lt; .001). EGS-LD patients were less likely to have surgery (26.1% vs 37.0%, P &lt; .001) but for those who did, mortality was higher (4.8% vs 1.8%, P &lt; .001). Risk factors for mortality included ascites (adjusted odds ratio [aOR] = 2.68, P &lt; .001), dialysis (aOR = 3.44, P &lt; .001), sepsis (aOR = 8.97, P &lt; .001), and respiratory failure requiring intubation (aOR = 10.40, P &lt; .001). Odds of death increased in both surgical (aOR = 4.93, P &lt; .001) and non-surgical EGS-LD patients (aOR = 2.56, P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Underlying all-cause LD among EGS patients is associated with increased in-hospital mortality, even in the absence of surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003134820923304","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T13:35:07Z","timestamp":1594820107000},"page":"665-674","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Understanding Health Care Utilization and Mortality After Emergency General Surgery in Patients With Underlying Liver Disease"],"prefix":"10.1177","volume":"86","author":[{"given":"Lakshika","family":"Tennakoon","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of General Surgery, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Baiu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of General Surgery, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waldo","family":"Concepcion","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Abdominal Transplantation, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc L.","family":"Melcher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Abdominal Transplantation, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Spain","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of General Surgery, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Knowlton","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of General Surgery, Stanford University Medical Center, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,15]]},"reference":[{"key":"bibr1-0003134820923304","unstructured":"Health, United States. 2017 \u2013 Data Finder. 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