Analysis of risk factors for overt hepatic encephalopathy and death after transjugular intrahepatic portosystemic shunt
10.3969/j.issn.1002-1671.2025.01.027
- VernacularTitle:经颈静脉肝内门体分流术后发生显性肝性脑病、死亡危险因素分析
- Author:
Kui ZHAN
1
;
Tianyou ZHANG
1
;
Shuigen HUANG
1
;
Shuqiang OU
1
;
Li XIN
1
;
Feiyuan WU
1
;
Yan QIU
1
;
Ning ZHANG
1
Author Information
1. 萍乡市第二人民医院肝病科,江西 萍乡 337000
- Publication Type:Journal Article
- Keywords:
liver cirrhosis;
portal hypertension;
transjugular intrahepatic portosystemic shunt;
hepatic encephalopathy;
death;
risk factors
- From:
Journal of Practical Radiology
2025;41(1):119-123
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of overt hepatic encephalopathy(OHE)and death in cirrhotic portal hyperten-sion patients after transjugular intrahepatic portosystemic shunt(TIPS).Methods A retrospective selection was conducted on 40 patients with cirrhotic portal hypertension who underwent TIPS.The follow-up time was 3-41 months,median follow-up time was 20.36 months.The postoperative hepatic encephalopathy(HE)were divided into OHE group(20 cases)and non-OHE group(20 cases)and were further divided into death group(11 cases)and survival group(29 cases)according to their postoperative survival status.Gender,age,preoperative height,weight,total bilirubin,albumin,alanine aminotransferase,aspartate aminotransferase,creatinine,international normalized ratio(INR),prothrombin time,blood glucose,white blood cells,hemoglobin and platelet of all patients were recorded in detail,as well as whether they had diabetes and portal thrombosis before surgery.Child score and model for end-stage liver disease(MELD)score were also performed.The related risk factors of HE and death were obtained by statistical analysis of the two groups.Results The incidence rate of OHE after TIPS was 50%.The analysis revealed that age[hazard ratio(HR)1.115,95%confidence interval(CI)1.007-1.234,P=0.036]and albumin(HR 0.776,95%CI 0.627-0.960,P=0.020)were independent risk factors for OHE after TIPS.The receiver operating characteristic(ROC)curves were drawn with area under the curve(AUC)of 0.733 for age and AUC of 0.784 for albumin.The mortality rate after TIPS was 27.5%,and the analysis indicated that albumin(HR 0.660,95%CI 0.453-0.961,P=0.030),creatinine(HR 1.031,95%CI 1.001-1.062,P=0.044),and aspartate aminotransferase(HR 1.074,95%CI 1.013-1.139,P=0.018)were independent risk factors for death after TIPS.The ROC curves were drawn with AUC of 0.716 for albumin,AUC of 0.762 for creatinine,and AUC of 0.710 for aspartate aminotransferase.Conclusion Postoperative OHE is posi-tively correlated with age and negatively correlated with albumin.Furthermore,the risk of postoperative death is positively correlated with creatinine and aspartate aminotransferase and negatively correlated with albumin.
