Transjugular intrahepatic portosystemic shunt for acute variceal bleeding in patients with viral liver cirrhosis: predictors of early mortality

AJR Am J Roentgenol. 2005 Oct;185(4):885-9. doi: 10.2214/AJR.04.0607.

Abstract

Objective: The purpose of our study was to assess the predictors of early mortality after the creation of transjugular intrahepatic portosystemic shunts (TIPS) for acute variceal bleeding in patients with viral liver cirrhosis.

Materials and methods: Seventy-three patients (56 men and 17 women; mean age, 51.3 years) with viral liver cirrhosis who underwent TIPS placement for acute variceal bleeding were studied. Multiple covariates, including demographic, clinical, and biochemical parameters, were included in univariate and multivariate analyses to determine their association with early (30-day) mortality.

Results: During the follow-up period (mean, 35 months 3 days), shunt dysfunction occurred in 33 patients (45.2%). Forty-three patients (58.9%) died, and 23 patients (31.5%) died within 30 days of TIPS. Early death was predicted independently by hyperbilirubinemia (> 3 mg/dL; p = 0.004; odds ratio, 10.6) and elevated serum creatinine level (> 1.7 mg/dL; p =0.018; odds ratio, 12.0).

Conclusion: Hyperbilirubinemia and elevated serum creatinine level are predictive of early mortality after TIPS creation for acute variceal bleeding in patients with viral liver cirrhosis.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Bilirubin / blood
  • Creatinine / blood
  • Esophageal and Gastric Varices / diagnostic imaging
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / mortality*
  • Esophageal and Gastric Varices / therapy*
  • Female
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / virology*
  • Logistic Models
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic / mortality*
  • Predictive Value of Tests
  • Recurrence
  • Retrospective Studies
  • Serum Albumin / analysis
  • Treatment Outcome
  • Ultrasonography, Doppler

Substances

  • Serum Albumin
  • Creatinine
  • Bilirubin