Recompensation after transjugular intrahepatic portosystemic shunt reduces mortality risk: A long-term follow-up study

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-04 DOI:10.1016/j.ejrad.2025.112212

Yaowei Bai , Jiacheng Liu , Yu Lei , Bo Sun , Wenlong Wu , Xiatong Bai , Yang Su , Wei Tan , Xuefeng Kan , Chuansheng Zheng

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Abstract

Objective

This study aims to analyze the occurrence of recompensation after transjugular intrahepatic portosystemic shunt (TIPS) for patients with cirrhosis and portal hypertension and its impact on mortality risk.

Methods

The clinical data of 621 cirrhotic patients who underwent TIPS creation were retrospectively analyzed. Patients were categorized into a recompensation group (n = 126) and a non-recompensation group (n = 495). Binary logistic regression was used to identify independent predictors of recompensation. Kaplan-Meier (KM) survival curves were employed to assess the differences in survival between the two groups, and the Cox proportional hazards model was utilized to analyze the risk factors for mortality.

Results

At 12 months after TIPS placement, 20.3 % of patients achieved recompensation. The recompensation group demonstrated significant improvements in both Child-Pugh and MELD scores (P < 0.05). Sarcopenia and platelet count (PLT) were identified as independent predictors of recompensation. The cumulative survival rate in the recompensation group was significantly higher than that of the non-recompensation group (HR = 2.275, 95 % CI = 1.606–3.223, Log-rank P < 0.001). Age, sarcopenia, and the occurrence of recompensation were identified as independent factors that influenced mortality risk.

Conclusion

TIPS was associated with recompensation in certain patients, and the occurrence of recompensation is significantly associated with improved long-term survival.

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经颈静脉肝内门静脉分流术后的再代偿降低了死亡风险：一项长期随访研究

目的分析肝硬化门静脉高压症患者经颈静脉肝内门静脉系统分流术（TIPS）后再代偿的发生情况及其对死亡风险的影响。方法回顾性分析621例肝硬化患者行TIPS术的临床资料。将患者分为再补偿组（n = 126）和非再补偿组（n = 495）。采用二元逻辑回归来确定补偿的独立预测因子。采用Kaplan-Meier （KM）生存曲线评价两组患者的生存差异，采用Cox比例风险模型分析死亡率的危险因素。结果TIPS放置12个月后，20.3%的患者获得了再补偿。补偿组Child-Pugh和MELD评分均有显著改善(P <；0.05)。肌少症和血小板计数（PLT）被确定为再代偿的独立预测因子。补偿组的累计生存率显著高于非补偿组(HR = 2.275, 95% CI = 1.606 ~ 3.223, Log-rank P <；0.001)。年龄、肌肉减少症和再补偿的发生被确定为影响死亡风险的独立因素。结论tips与部分患者的再代偿相关，再代偿的发生与长期生存率的提高显著相关。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.