Effect of the multidisciplinary management model on the prognosis of patients with portal hypertension

Changxiang LAI; Qiyuan TANG; Zhiyu LI; Yujin JIANG; Xuan ZHOU; Wenjie XIAN; Ruikun CHEN; Xiaojuan WU; Qing HE; Fang WANG

Return

Effect of the multidisciplinary management model on the prognosis of patients with portal hypertension

VernacularTitle:多学科管理模式对门静脉高压患者预后的影响
Author: Changxiang LAI ¹ ; Qiyuan TANG ¹ ; Zhiyu LI ¹ ; Yujin JIANG ¹ ; Xuan ZHOU ¹ ; Wenjie XIAN ¹ ; Ruikun CHEN ¹ ; Xiaojuan WU ¹ ; Qing HE ¹ ; Fang WANG ¹
Author Information

1. Shenzhen Third People’s Hospital， Hepatology Medical Center of The Second Affiliated Hospital of Southern University of Science and Technology， National Key Discipline of Infectious Diseases， Shenzhen， Guangdong 518116， China
Publication Type:Journal Article
Keywords: Liver Cirrhosis; Hypertension， Portal; Multidisciplinary Diagnosis and Treatment; Prognosis
From: Journal of Clinical Hepatology 2025;41(10):2068-2074
CountryChina
Language:Chinese
Abstract: ObjectiveTo investigate the effect of the multidisciplinary team （MDT） management model in improving the prognosis of patients with cirrhotic portal hypertension. MethodsA total of 86 patients with cirrhotic portal hypertension who were admitted to Shenzhen Third People’s Hospital from May 2022 to July 2024 were enrolled， and according to whether the MDT treatment regimen was implemented， they were divided into execution group with 51 patients and non-execution group with 35 patients. Baseline clinical data were collected， and the patients were observed in terms of gastrointestinal bleeding， hepatic encephalopathy， liver cancer， and death from admission to the end of follow-up （January 2025）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves for the cumulative incidence rates of endpoint events （gastrointestinal bleeding， hepatic encephalopathy， liver cancer， and death）， and the Log-rank test was used for comparison between groups. The Cox proportional-hazards regression model analysis was used to investigate the effect of MDT management on the prognosis of patients. ResultsThere were significant differences between the execution group and the non-execution group in diameter of the portal vein （t=1.216， P=0.017） and ascites （χ²=4.515， P=0.034） at baseline. The patients were followed up for 14.6±6.2 months， and the survival curve analysis showed that there was a significant difference in the cumulative incidence rate of gastrointestinal bleeding between the two groups （χ²=4.573， P=0.024）， while there were no significant differences in the incidence rates of other outcome events between the two groups （all P>0.05）. The Cox regression analysis showed that the execution group had a reduced risk of gastrointestinal bleeding （hazard ratio=0.262， 95% confidence interval： 0.110 — 0.630， P=0.003）. ConclusionImplementation of the MDT treatment regimen can significantly reduce the short-term risk of gastrointestinal bleeding in patients with cirrhotic portal hypertension， while its long-term benefits require further follow-up verification.