Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.

BACKGROUND AND AIMS: Patients with decompensated cirrhosis frequently require hospital admissions, which are associated with worse prognosis. The aim of this study was to analyze the effect of TIPS on the need for hospital care. Secondary objectives were to assess the clinical and biological impact...

Descripción completa

Detalles Bibliográficos
Autores: Ballester, MP, Lluch, P, Gomez, C, Capilla, M, Tosca, J, Marti-Aguado, D, Guijarro, J, Minguez, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15436
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/15436
Access Level:acceso abierto
Palabra clave:Care, medical
Hypertension, portal
Liver cirrhosis
Portosystemic shunt, transjugular intrahepatic
id ES_fffe47b5f3347eb7b1551821eea071da
oai_identifier_str oai:incliva.fundanetsuite.com:p15436
network_acronym_str ES
network_name_str España
repository_id_str
spelling Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.Ballester, MPLluch, PGomez, CCapilla, MTosca, JMarti-Aguado, DGuijarro, JMinguez, MCare, medicalHypertension, portalLiver cirrhosisPortosystemic shunt, transjugular intrahepaticBACKGROUND AND AIMS: Patients with decompensated cirrhosis frequently require hospital admissions, which are associated with worse prognosis. The aim of this study was to analyze the effect of TIPS on the need for hospital care. Secondary objectives were to assess the clinical and biological impact of TIPS and to identify predictors of post-TIPS hospital care. METHODS: An observational, retrospective study of patients with decompensated cirrhosis treated with TIPS from January 2008 until March 2019. Exclusion criteria were TIPS placed for non-cirrhotic portal hypertension (PH) and patients referred from another hospital without prior or subsequent follow-up at our Unit. Hospital care, PH-related complications, and laboratory data were compared before and after TIPS. RESULTS: The final cohort comprised 104 patients (72% male) with a mean age of 60 (± 10) years. Follow-up from first decompensation until TIPS and that from procedure to study completion were 7 (4.2-9.8) and 20 (4.6-35.4) months, respectively. TIPS was indicated mainly for refractory ascites (50%) and variceal bleeding (39%). Hemodynamic and clinical success rates were 97% and 92%, respectively. The number of emergency department visits and hospital admissions decreased after the procedure (p < 0.001). Improvement was seen in MELD and Child-Pugh scores, renal function, hyponatremia, and anemia after TIPS. Variceal bleeding as the indication for TIPS (OR 0.047; 95 CI 0.006-0,39; p < 0.05) together with early creation of the shunt (stage 3 vs 5; p < 0.05) were associated with a reduction in risk of post-TIPS hospital care. CONCLUSION: TIPS is a safe and effective procedure that reduces hospital care burden by improving PH-related complications, hepatic, renal function, hyponatremia, and anemia. Variceal bleeding as the indication and early placement of the device were associated with a reduction in post-TIPS hospital care. These findings support a role for this treatment, predominantly in the early stages of cirrhosis.SPRINGER-VERLAG ITALIA SRL2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/15436Internal and Emergency MedicineISSN: 18280447ISSNe: 19709366reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p154362026-06-07T16:35:31Z
dc.title.none.fl_str_mv Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
title Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
spellingShingle Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
Ballester, MP
Care, medical
Hypertension, portal
Liver cirrhosis
Portosystemic shunt, transjugular intrahepatic
title_short Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
title_full Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
title_fullStr Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
title_full_unstemmed Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
title_sort Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrhosis.
dc.creator.none.fl_str_mv Ballester, MP
Lluch, P
Gomez, C
Capilla, M
Tosca, J
Marti-Aguado, D
Guijarro, J
Minguez, M
author Ballester, MP
author_facet Ballester, MP
Lluch, P
Gomez, C
Capilla, M
Tosca, J
Marti-Aguado, D
Guijarro, J
Minguez, M
author_role author
author2 Lluch, P
Gomez, C
Capilla, M
Tosca, J
Marti-Aguado, D
Guijarro, J
Minguez, M
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Care, medical
Hypertension, portal
Liver cirrhosis
Portosystemic shunt, transjugular intrahepatic
topic Care, medical
Hypertension, portal
Liver cirrhosis
Portosystemic shunt, transjugular intrahepatic
description BACKGROUND AND AIMS: Patients with decompensated cirrhosis frequently require hospital admissions, which are associated with worse prognosis. The aim of this study was to analyze the effect of TIPS on the need for hospital care. Secondary objectives were to assess the clinical and biological impact of TIPS and to identify predictors of post-TIPS hospital care. METHODS: An observational, retrospective study of patients with decompensated cirrhosis treated with TIPS from January 2008 until March 2019. Exclusion criteria were TIPS placed for non-cirrhotic portal hypertension (PH) and patients referred from another hospital without prior or subsequent follow-up at our Unit. Hospital care, PH-related complications, and laboratory data were compared before and after TIPS. RESULTS: The final cohort comprised 104 patients (72% male) with a mean age of 60 (± 10) years. Follow-up from first decompensation until TIPS and that from procedure to study completion were 7 (4.2-9.8) and 20 (4.6-35.4) months, respectively. TIPS was indicated mainly for refractory ascites (50%) and variceal bleeding (39%). Hemodynamic and clinical success rates were 97% and 92%, respectively. The number of emergency department visits and hospital admissions decreased after the procedure (p < 0.001). Improvement was seen in MELD and Child-Pugh scores, renal function, hyponatremia, and anemia after TIPS. Variceal bleeding as the indication for TIPS (OR 0.047; 95 CI 0.006-0,39; p < 0.05) together with early creation of the shunt (stage 3 vs 5; p < 0.05) were associated with a reduction in risk of post-TIPS hospital care. CONCLUSION: TIPS is a safe and effective procedure that reduces hospital care burden by improving PH-related complications, hepatic, renal function, hyponatremia, and anemia. Variceal bleeding as the indication and early placement of the device were associated with a reduction in post-TIPS hospital care. These findings support a role for this treatment, predominantly in the early stages of cirrhosis.
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/15436
url https://incliva.portalinvestigacion.com/publicaciones/15436
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 SPRINGER-VERLAG ITALIA SRL
publisher.none.fl_str_mv SPRINGER-VERLAG ITALIA SRL
dc.source.none.fl_str_mv Internal and Emergency Medicine
ISSN: 18280447
ISSNe: 19709366
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
_version_ 1869425824724156416
score 15,812455

Similares en LA Referencia