Pre-existing Hepatic Encephalopathy: Really a Contraindication to Elective TIPS?
- 05.10.2023
- Clinical Investigation
Erschienen in:
- Verfasst von
- Pooya Torkian
- Stephanie Wallace
- Nicholas Lim
- Siobhan Flanagan
- Jafar Golzarian
- Shamar J. Young
- Erschienen in
- CardioVascular and Interventional Radiology | Ausgabe 1/2024
Abstract
Purpose
To evaluate the impact of pre-transjugular intrahepatic portosystemic shunt (TIPS) hepatic encephalopathy (HE) on developing post-TIPS HE.
Materials and Methods
In this retrospective, single center observational study, all patients who underwent successful TIPS placement between January 2005 and May 2020 with data pertaining to HE in their chart were included. Patient demographics and procedural details were recorded. Clinical outcomes post-TIPS, were collected and compared across patients with and without pre-TIPS HE.
Results
Of 326 included patients, 159 (159/326, 48.8%) had a history of pre-TIPS HE. In total those without a history of HE were more likely to develop HE during follow up (136 (136/167, 81.4%) vs 107 (107/159, 67.3%), p = 0.001). When evaluating for predictors of developing HE within 3 months of TIPS placement, no significant variables were found on logistic regression, including prior history of HE (HR 1.16 (95% CI 0.73–1.84), p = 0.529). Univariate and multivariate regression analysis, however, showed that a history of HE was predictive of developing HE at any point in the follow-up period (p = 0.002 and p = 0.008, respectively). However, on Kaplan–Meier analysis no significant difference in the development of HE (p = 0.574) or hospital admission for HE (p = 0.554) post-TIPS was seen between patients with and without pre-TIPS HE. Additionally, there was no difference in 3-month survival (p = 0.412) or overall survival post-TIPS survival (p = 0.798).
Conclusion
Pre-TIPS HE did not predict the development of HE within 3 months of TIPS. Outcomes such as hospital admission and survivability were not different between patients with and without prior HE.
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- Titel
- Pre-existing Hepatic Encephalopathy: Really a Contraindication to Elective TIPS?
- Verfasst von
-
Pooya Torkian
Stephanie Wallace
Nicholas Lim
Siobhan Flanagan
Jafar Golzarian
Shamar J. Young
- Publikationsdatum
- 05.10.2023
- Verlag
- Springer US
- Erschienen in
-
CardioVascular and Interventional Radiology / Ausgabe 1/2024
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X - DOI
- https://doi.org/10.1007/s00270-023-03566-z
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