Evidence map›Paper›PMID 33400160›Full record

Observational studyInternal and emergency medicine2021

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

Maria Pilar Ballester, Paloma Lluch, Concepción Gómez, Maria Capilla, Joan Tosca, David Martí-Aguado, Jorge Guijarro, Miguel Mínguez

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Internal and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Maria Pilar BallesterDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain. mapibafe@gmail.com.ORCID 0000-0001-7177-5696
Paloma LluchDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.
Concepción GómezDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.
Maria CapillaDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.
Joan ToscaDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.
David Martí-AguadoDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.
Jorge GuijarroInterventional Radiology Department, Clinic University Hospital of Valencia, Valencia, Spain.
Miguel MínguezDigestive Disease Department, Clinic University Hospital of Valencia, Blasco Ibañez 17, 46010, Valencia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsPatients 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.

methodsAn 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.

resultsThe 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.

conclusionTIPS 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.

Indexed as

Cost of IllnessAgedFemaleFibrosisHospitalsHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedPortasystemic Shunt, Transjugular IntrahepaticRetrospective StudiesTreatment OutcomeCare, medicalHypertension, portalLiver cirrhosisPortosystemic shunt, transjugular intrahepatic

Identifiers

PMID33400160

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.