Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt

Background: Malnutrition is frequent in patients with cirrhosis and has been associated with poor prognosis. The Model for End-stage Liver Disease (MELD) score was created to predict survival after Transjugular Intrahepatic Porto-systemic Shunt (TIPS) but lacks a nutritional parameter. Aims: To eval...

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Authors: Ballester, MP, Lluch, P, Tosca, J, Capilla, M, Gómez, C, Moreno, O, Jordán-Iborra, C, Sunsundegui, P, Argemi, J, Guijarro, J, Mínguez, M
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:INCLIVA
Repository:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p19755
Online Access:https://incliva.portalinvestigacion.com/publicaciones/19755
Access Level:Open access
Keyword:Cholesterol
Portal hypertension
Liver cirrhosis
Transjugular intrahepatic
Portosystemic shunt
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spelling Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shuntBallester, MPLluch, PTosca, JCapilla, MGómez, CMoreno, OJordán-Iborra, CSunsundegui, PArgemi, JGuijarro, JMínguez, MCholesterolPortal hypertensionLiver cirrhosisTransjugular intrahepaticPortosystemic shuntBackground: Malnutrition is frequent in patients with cirrhosis and has been associated with poor prognosis. The Model for End-stage Liver Disease (MELD) score was created to predict survival after Transjugular Intrahepatic Porto-systemic Shunt (TIPS) but lacks a nutritional parameter. Aims: To evaluate the prognostic value of serum cholesterol in patients with cirrhosis undergoing TIPS and to develop a prognostic score to predict survival. Methods: An explorative cross-sectional study was conducted of cirrhotic patients undergoing TIPS from 2008 until 2019. Exclusion criteria were liver transplantation or hepatocellular carcinoma before TIPS. Risk analysis was used to compare survival according to clinical and analytical data. The diagnostic performance of serum cholesterol added to MELD was evaluated and confirmed in an external validation cohort. Results: The final cohort of 100 patients had a mean MELD score of 14 +/- 5 and cholesterol of 122 +/- 51 mg/dL. MELD (p < 0,05) and both cholesterol (p < 0,05) and low-density lipoprotein levels (LDLC) (p < 0,05) were independent predictors of post-TIPS transplant-free survival with an optimal cut-off of 106 mg/dL for serum cholesterol. The combined MELD-cholesterol risk score improved diagnostic accuracy of each parameter separately, and this was confirmed in the external cohort. Conclusion: Serum cholesterol and LDL-C are independent predictors of transplant-free survival in cirrhotic patients undergoing TIPS. The MELD-cholesterol score slightly improved prognostic accuracy. Lay Summary: As an objective and easily measured indicator of both nutritional status and hepatic function, serum cholesterol could be useful to predict transplant-free survival in patients with cirrhosis undergoing TIPS. It can enable health care providers to identify high-risk patients and to optimize nutritional status before TIPS. (C) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.ELSEVIER SCIENCE INC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/19755DIGESTIVE AND LIVER DISEASEISSN: 15908658ISSNe: 18783562reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p197552026-06-07T16:35:31Z
dc.title.none.fl_str_mv Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
title Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
spellingShingle Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
Ballester, MP
Cholesterol
Portal hypertension
Liver cirrhosis
Transjugular intrahepatic
Portosystemic shunt
title_short Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
title_full Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
title_fullStr Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
title_full_unstemmed Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
title_sort Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt
dc.creator.none.fl_str_mv Ballester, MP
Lluch, P
Tosca, J
Capilla, M
Gómez, C
Moreno, O
Jordán-Iborra, C
Sunsundegui, P
Argemi, J
Guijarro, J
Mínguez, M
author Ballester, MP
author_facet Ballester, MP
Lluch, P
Tosca, J
Capilla, M
Gómez, C
Moreno, O
Jordán-Iborra, C
Sunsundegui, P
Argemi, J
Guijarro, J
Mínguez, M
author_role author
author2 Lluch, P
Tosca, J
Capilla, M
Gómez, C
Moreno, O
Jordán-Iborra, C
Sunsundegui, P
Argemi, J
Guijarro, J
Mínguez, M
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cholesterol
Portal hypertension
Liver cirrhosis
Transjugular intrahepatic
Portosystemic shunt
topic Cholesterol
Portal hypertension
Liver cirrhosis
Transjugular intrahepatic
Portosystemic shunt
description Background: Malnutrition is frequent in patients with cirrhosis and has been associated with poor prognosis. The Model for End-stage Liver Disease (MELD) score was created to predict survival after Transjugular Intrahepatic Porto-systemic Shunt (TIPS) but lacks a nutritional parameter. Aims: To evaluate the prognostic value of serum cholesterol in patients with cirrhosis undergoing TIPS and to develop a prognostic score to predict survival. Methods: An explorative cross-sectional study was conducted of cirrhotic patients undergoing TIPS from 2008 until 2019. Exclusion criteria were liver transplantation or hepatocellular carcinoma before TIPS. Risk analysis was used to compare survival according to clinical and analytical data. The diagnostic performance of serum cholesterol added to MELD was evaluated and confirmed in an external validation cohort. Results: The final cohort of 100 patients had a mean MELD score of 14 +/- 5 and cholesterol of 122 +/- 51 mg/dL. MELD (p < 0,05) and both cholesterol (p < 0,05) and low-density lipoprotein levels (LDLC) (p < 0,05) were independent predictors of post-TIPS transplant-free survival with an optimal cut-off of 106 mg/dL for serum cholesterol. The combined MELD-cholesterol risk score improved diagnostic accuracy of each parameter separately, and this was confirmed in the external cohort. Conclusion: Serum cholesterol and LDL-C are independent predictors of transplant-free survival in cirrhotic patients undergoing TIPS. The MELD-cholesterol score slightly improved prognostic accuracy. Lay Summary: As an objective and easily measured indicator of both nutritional status and hepatic function, serum cholesterol could be useful to predict transplant-free survival in patients with cirrhosis undergoing TIPS. It can enable health care providers to identify high-risk patients and to optimize nutritional status before TIPS. (C) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/19755
url https://incliva.portalinvestigacion.com/publicaciones/19755
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv DIGESTIVE AND LIVER DISEASE
ISSN: 15908658
ISSNe: 18783562
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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