Trauma in the Patient with Cirrhosis

Trauma patients with cirrhosis have higher than predicted mortality. Mortality increases with increasing MELD or Child-Pugh classification. Early deaths after injury in cirrhotic patients are from hemorrhage; late deaths are a consequence of infection. The common scoring systems (TRISS and ISS) to predict mortality in trauma patients are unreliable in cirrhotic patients. Operative mortality is dramatically higher in the cirrhotic patient undergoing laparotomy for trauma as compared to noncirrhotic patients.