The burden of cirrhosis is increasing, as is the need for surgeries in patients with cirrhosis. These patients have increased surgical risk relative to non-cirrhotic patients. Unfortunately, currently available cirrhosis surgical risk prediction tools are non-specific, poorly calibrated, limited in scope, and/or outdated. The Mayo score is the only dedicated tool to provide discrete post-operative mortality predictions for patients with cirrhosis, however it has several limitations. First, its single-center nature does not reflect institution-specific practices that may impact surgical risk. Second, it pre-dates major surgical changes that have changed the landscape of patient selection and surgical risk. Third, it has been shown to overestimate risk in external validation. Finally, and perhaps most importantly, the score does not account for differences in risk based on surgery type. The clinical consequences of inaccurate prediction and risk overestimation are significant, as patients with otherwise acceptable risk may be denied elective surgical procedures, thereby increasing their future need for higher-risk emergent procedures. Confident evaluation of the risks and benefits of surgery in this growing population requires an updated, generalizable, and accurate cirrhosis surgical risk calculator that incorporates the type of surgery under consideration.

肝硬化的负担在增加，肝硬化患者进行手术的需求也在增加。相对于非肝硬化患者，这些患者的手术风险增加。不幸的是，当前可用的肝硬化手术风险预测工具是非特异性的，校准不良，范围有限和/或已过时。Mayo评分是唯一可为肝硬化患者提供离散的术后死亡率预测的专用工具，但是它有一些局限性。首先，其单一中心性质并不反映可能影响手术风险的特定于机构的做法。其次，它在重大外科手术改变之前就已经发生，从而改变了患者选择和外科手术风险的面貌。第三，它已被证明高估了外部验证中的风险。最后，也许最重要的是，该分数未考虑基于手术类型的风险差异。不准确的预测和高估风险的临床后果非常显着，因为原本可以接受的风险患者可能会被拒绝接受选择性外科手术，从而增加了他们对更高风险的紧急手术的需求。要对不断增长的人口中的手术风险和益处进行可靠的评估，就需要一个更新，可推广且准确的肝硬化手术风险计算器，其中应考虑所考虑的手术类型。