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Care of the critically ill patient with cirrhosis of the liver is a significant challenge for all surgeons and intensivists. The occurrence of a traumatic injury in a patient with otherwise compensated liver disease may lead to acute-on-chronic liver failure with a high risk of death, even after relatively minor injuries.1 During my training, a senior trauma surgeon taught us that “cirrhosis plus x = death, and x can be just about anything.” Unfortunately, that adage remains all too true today.
Pritts TA. Use of Model for End-Stage Liver Disease Scoring Dynamics in Critically Ill Cirrhotic Trauma Patients. JAMA Surg. 2016;151(1):48-49. doi:10.1001/jamasurg.2015.3154