{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:56:17Z","timestamp":1777938977100,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T00:00:00Z","timestamp":1632614400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background &amp; objective:<\/jats:title>\n                    <jats:p>While splenectomy is performed for various trauma and non-trauma indications, there is little information about the impact of cirrhosis on the post-splenectomy outcomes, despite the intricate physiological and vascular connection between the liver and the spleen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>2011\u20132017 National Inpatient Sample was used to select patient cases who underwent the splenectomy procedure, who were further stratified using cirrhosis. The cirrhosis-absent controls were matched to the study cohort using propensity score matching with nearest neighbor matching method. Endpoints included mortality, length of stay, hospitalization costs, and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 675 patients with cirrhosis and 675 matched controls identified from the database. Cirrhosis cohort had higher mortality (20.0 vs 7.26%, p\u2009&lt;\u20090.001, OR = 3.19, 95% CI = 2.26\u20134.52) and hospitalization costs ($210,716 vs $186,673, p\u2009=\u20090.003), but shorter length of stay (11.8 vs 12.5d, p\u2009=\u20090.04). In terms of complications, cirrhosis cohorts had higher postoperative bleeding (7.26 vs 4.3%, p\u2009=\u20090.027, OR = 1.74, 95% CI = 1.09\u20132.80) and shock (3.7 vs 1.04%, p\u2009=\u20090.002, OR = 3.67, 95% CI = 1.58\u20138.54), and were more likely to be discharged to short-term hospitals and home with home health care. On multivariate analysis, presence of cirrhosis resulted in higher mortality (p\u2009&lt;\u20090.001, aOR = 3.30, 95% CI = 2.33\u20134.69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Cirrhosis is an independent risk factor of postoperative mortality in patients undergoing splenectomy; given this finding, further precautious and multidisciplinary care should be rendered in these at-risk patients with cirrhosis in the setting of splenectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969211042457","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T02:53:48Z","timestamp":1632711228000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of cirrhosis on the postoperative outcomes of patients undergoing splenectomy: Propensity score matched analysis of the 2011\u20132017 US hospital database"],"prefix":"10.1177","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7129-7532","authenticated-orcid":false,"given":"David U.","family":"Lee","sequence":"first","affiliation":[{"name":"Liver Center, Division of Gastroenterology and Hepatology, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory H.","family":"Fan","sequence":"additional","affiliation":[{"name":"Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Hastie","sequence":"additional","affiliation":[{"name":"Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elyse A.","family":"Addonizio","sequence":"additional","affiliation":[{"name":"Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffi","family":"Karagozian","sequence":"additional","affiliation":[{"name":"Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,9,26]]},"reference":[{"key":"bibr1-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195909000-00007"},{"key":"bibr2-14574969211042457","doi-asserted-by":"publisher","DOI":"10.3350\/kjhep.2010.16.4.347"},{"key":"bibr3-14574969211042457","first-page":"192","volume":"121","author":"Friedman LS","year":"2010","journal-title":"Trans Am Clin Climatol Assoc"},{"key":"bibr4-14574969211042457","doi-asserted-by":"publisher","DOI":"10.4103\/1319-3767.65181"},{"key":"bibr5-14574969211042457","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i30.4056"},{"key":"bibr6-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2012.05.003"},{"key":"bibr7-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1985.01390300019003"},{"key":"bibr8-14574969211042457","doi-asserted-by":"publisher","DOI":"10.4293\/108680809X12589999537959"},{"key":"bibr9-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1177\/1179552217746645"},{"key":"bibr10-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-003-9222-6"},{"key":"bibr11-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-742353"},{"issue":"4","key":"bibr12-14574969211042457","first-page":"499","volume":"10","author":"Dissanaike S","year":"2006","journal-title":"JSLS"},{"key":"bibr13-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001991"},{"key":"bibr14-14574969211042457","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2021.01.005."},{"key":"bibr15-14574969211042457","unstructured":"Healthcare Cost and Utilization Project (HCUP): 2017 Introduction to the HCUP National Inpatient Sample (NIS). 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