Figure 55-6 Effect of the number of risk factors on the perioperative complication rate in cirrhotic patients undergoing surgery. Risk factors included the Child-Pugh score, the presence of ascites, a diagnosis of cirrhosis other than primary biliary cirrhosis, serum creatinine concentration, a diagnosis of chronic obstructive pulmonary disease, preoperative infection, preoperative upper gastrointestinal bleeding, higher American Society of Anesthesiologists physical status score, intraoperative hypotension, and higher surgical severity score. (From Ziser A, Plevak DJ, Wiesner RH, et al: Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology 90:42–53, 1999.)