Chang Jin Yoon1, Jin Wook Chung, Jae Hyung Park. 1. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, 28 Yongon-Dong, Chongno-Gu, Seoul 110-774, South Korea. chungjw@radcom.snu.ac.kr
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.
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.
Authors: Hyung Ki Kim; Yoon Jun Kim; Woo Jin Chung; Soon Sun Kim; Jae Jun Shim; Moon Seok Choi; Do Young Kim; Dae Won Jun; Soon Ho Um; Sung Jae Park; Hyun Young Woo; Young Kul Jung; Soon Koo Baik; Moon Young Kim; Soo Young Park; Jae Myeong Lee; Young Seok Kim Journal: Clin Mol Hepatol Date: 2014-03-26
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