{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:45:04Z","timestamp":1791974704636,"version":"4.4.0"},"reference-count":12,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Pericardiectomy for constrictive pericarditis remains a high-risk operation, and early outcomes are inadequately predicted by conventional cardiac risk models despite the high prevalence of chronic hepatic congestion in this population. We performed a retrospective observational analysis of 104 consecutive patients undergoing isolated pericardiectomy between 2010 and 2024 to determine whether established hepatic scoring systems [Child-Pugh, Model for End-Stage Liver Disease (MELD) and Model for End-Stage Liver Disease-Sodium (MELD-Na)] predict early mortality and major postoperative morbidity. Preoperative clinical and biochemical variables were used to derive the hepatic scores. The primary endpoint was 30-day mortality; the secondary endpoint was new postoperative renal-replacement therapy. Thirty-day mortality was 4.8% (5\/104). Patients were classified as Child-Pugh A in 66 (63.5%), B in 35 (33.7%), and C in 3 (2.9%), with corresponding mortalities of 1.5%, 2.9%, and 100% (p&lt;0.01 for trend). Discrimination for 30-day mortality was strong for Child-Pugh [area under the receiver operating characteristic curve (AUC) 0.89, 95% confidence interval 0.73-1.00], MELD (0.85, 0.60-0.98), and MELD-Na (0.83, 0.55-0.97), whereas EuroSCORE II showed no meaningful predictive ability (AUC\u22480.51). Hepatic dysfunction quantified by Child-Pugh and MELD-based scores is a strong predictor of early mortality after pericardiectomy and outperforms conventional cardiac risk models in this cohort. Incorporation of structured hepatic assessment into preoperative risk stratification may improve perioperative planning and patient counseling; however, the small number of Child-Pugh C patients and the retrospective single-center design necessitate validation in larger prospective cohorts.<\/jats:p>","DOI":"10.4081\/monaldi.2026.3956","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:50:47Z","timestamp":1791971447000},"source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of liver scoring systems in predicting early outcomes after pericardiectomy: a single-center retrospective study"],"prefix":"10.4081","author":[{"given":"Mahmoud","family":"AlShiekh","sequence":"first","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayakumar","family":"Muppiri","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Helal","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Bazerbashi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviral","family":"Sethi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udit","family":"Kathuria","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aladdin","family":"Bashir","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Allam","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Dalrymple-Hay","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"89001","unstructured":"Komoda T, Tanaka K, Matsumiya G, et al. Constrictive pericarditis causes hepatic congestion leading to congestive hepatopathy and cardiac cirrhosis. Ann Thorac Surg 2013;96:445-52."},{"key":"89002","doi-asserted-by":"crossref","unstructured":"Tzani A, Doulamis IP, Tzoumas A, et al. Meta-analysis of population characteristics and outcomes of patients undergoing pericardiectomy for constrictive pericarditis. Am J Cardiol 2021;146:120-7.","DOI":"10.1016\/j.amjcard.2021.01.033"},{"key":"89003","doi-asserted-by":"crossref","unstructured":"Murashita T, Schaff HV, Daly RC, et al. Experience with pericardiectomy for constrictive pericarditis over eight decades. Ann Thorac Surg 2017;104:742-50.","DOI":"10.1016\/j.athoracsur.2017.05.063"},{"key":"89004","doi-asserted-by":"crossref","unstructured":"Komoda T, Frumkin A, Knosalla C, Hetzer R. Child-Pugh score predicts survival after radical pericardiectomy for constrictive pericarditis. Ann Thorac Surg 2013;96:1679-85.","DOI":"10.1016\/j.athoracsur.2013.06.016"},{"key":"89005","doi-asserted-by":"crossref","unstructured":"Szab\u00f3 G, Schmack B, Bulut C, et al. Constrictive pericarditis: risks, aetiologies and outcomes after total pericardiectomy: 24 years of experience. Eur J Cardiothorac Surg 2013;44:1023-8.","DOI":"10.1093\/ejcts\/ezt138"},{"key":"89006","doi-asserted-by":"crossref","unstructured":"Nashef SAM, Roques F, Sharples LD, et al. EuroSCORE II. Eur J Cardiothorac Surg 2012;41:734-45.","DOI":"10.1093\/ejcts\/ezs043"},{"key":"89007","doi-asserted-by":"crossref","unstructured":"Ahmed Z, Seibert A. Constrictive pericarditis as a rare cause of cardiac cirrhosis. Biomed J Sci Tech Res 2020;27:21434-6.","DOI":"10.26717\/BJSTR.2020.29.004843"},{"key":"89008","doi-asserted-by":"crossref","unstructured":"Radakovic D, Opacic D, B\u00f6rgermann J, et al. Model for end-stage liver disease predicts mortality after pericardiectomy for constrictive pericarditis. Interact Cardiovasc Thorac Surg 2018;27:813-8.","DOI":"10.1093\/icvts\/ivy182"},{"key":"89009","doi-asserted-by":"crossref","unstructured":"Pugh RNH, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646-9.","DOI":"10.1002\/bjs.1800600817"},{"key":"89010","doi-asserted-by":"crossref","unstructured":"Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33:464-70.","DOI":"10.1053\/jhep.2001.22172"},{"key":"89011","doi-asserted-by":"crossref","unstructured":"Suman A, Barnes DS, Zein NN, et al. Predicting outcome after cardiac surgery in patients with cirrhosis: comparison of Child-Pugh and MELD scores. Clin Gastroenterol Hepatol 2004;2:719-23.","DOI":"10.1016\/S1542-3565(04)00296-4"},{"key":"89012","doi-asserted-by":"crossref","unstructured":"Gopaldas RR, Dao TK, Caron NR, Markley JG. Predictors of in-hospital complications after pericardiectomy: a nationwide outcomes study. J Thorac Cardiovasc Surg 2013;145:1227-33.","DOI":"10.1016\/j.jtcvs.2012.03.072"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3956\/2297","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3956\/2297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:50:53Z","timestamp":1791971453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/3956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":12,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.3956","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,14]]}}}