Aminopyrine Breath Test Predicts Surgical Risk for Patients with Liver Disease

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Abstract
To determine whether the [14C]aminopyrine breath test (ABT) predicts surgical risk in patients with liver disease, it was obtained prior to various surgeries in 38 patients with known or suspected liver disease. A modified Child''s classification was also determined. Six of the 7 operative deaths (3 Child''s A, 2 B, 2 C) and ABT < 2.3%, while 30 of 31 survivors (24 Child''s A, 7 B) had ABT > 2.3% (P < 0.000018). Seven of the 16 patients with normal ABT had biopsy-proven cirrhosis and had postoperative courses indistinguishable from the remainder of the group. Surgery in patients with ABT < 2.3% apparently is associated with extremely high mortality. In addition, cirrhotics with normal ABT tolerate elective surgery well.