Evidence map›Paper›PMID 34324168›Full record

ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2021

Transjugular intrahepatic portosystemic shunt (TIPS) placement at index portal hypertensive decompensation (anticipant TIPS) in cirrhosis and the role of early intervention in variceal bleeding and ascites.

Sasidharan Rajesh, Cyriac Abby Philips, Somsharan Shankerappa Betgeri, Tom George, Rizwan Ahamed, Meera Mohanan, Philip Augustine

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In one paragraph

Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Double C-Arm Digital Subtraction Angiography Guidance During Transjugular Intrahepatic Portosystemic Shunt Placement.Medical science monitor : international medical journal of experimental and clinical research · 2023
    Article
  6. Editorial commentary on Indian Journal of Gastroenterology-July-August 2021.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021
    Article
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

7 authors at 3 institutions in 2 countries.

Sasidharan RajeshInterventional Radiology, Ernakulam Medical Center, Kochi 682 028, India.
Cyriac Abby PhilipsThe Liver Unit and Monarch Liver Lab, Ernakulam Medical Center, Kochi 682 028, India. abbyphilips@gmail.com.ORCID http://orcid.org/0000-0002-9587-336X
Somsharan Shankerappa BetgeriInterventional Radiology, Caritas Hospital, Kottayam 686 630, India.
Tom GeorgeInterventional Radiology, Ernakulam Medical Center, Kochi 682 028, India.
Rizwan AhamedGastroenterology and Advanced G.I. Endoscopy, Ernakulam Medical Center, Kochi 682 028, India.
Meera MohananDepartment of Anaesthesia and Critical Care, Ernakulam Medical Center, Kochi 682 028, India.
Philip AugustineGastroenterology and Advanced G.I. Endoscopy, Ernakulam Medical Center, Kochi 682 028, India.
General Hospital Ernakulam · INCaritas Hospital · INMorpho (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransjugular intrahepatic portosystemic shunt (TIPS) placement improves survival in patients with refractory/recurrent acute variceal bleeding (RAVB) and refractory ascites/hydrothorax. Recently, early TIPS was shown to reduce rebleeding and improve survival compared to the conventional TIPS. We aimed to study outcomes in patients with cirrhosis undergoing TIPS at first significant portal hypertensive (PHT) decompensation (termed anticipant TIPS) compared to those undergoing TIPS for recurrent or persistent PHT complications (conventional) and compared the former to matched controls on standard medical management (SMT).

methodsWe retrospectively analyzed the clinical, biochemical, and liver disease severity parameters and survival at baseline and post-intervention in cirrhosis patients at two major hepatobiliary intervention centers undergoing anticipant (n = 27) or conventional TIPS (n = 30) and compared the former group to matched historical controls on SMT (n = 35).

resultsBaseline parameters were comparable between both the groups, including the Child-Pugh class and model for end-stage liver disease (MELD) scores. Length of stay in the intensive care unit, post-procedure admission rates, and sepsis events were higher among patients undergoing conventional TIPS (p < 0.05). Post-TIPS, at 1 year, overall and sub-grouped survivals were   better in patients undergoing anticipant TIPS. On further sub-group analysis, based on the PHT events and stratified based on Child-Pugh and MELD scores, a higher proportion of patients survived after anticipant TIPS at 1 year. Compared to SMT, patients undergoing anticipant TIPS had significantly lesser hospitalizations, recurrence of varices, and ascites at 1 year, reducing hospital visits and financial burden.

conclusionsAnticipant TIPS at the first significant PHT event could improve liver-related events and survival compared to   standard medical management and conventional TIPS, respectively.

Indexed as

AscitesEnd Stage Liver DiseaseEsophageal and Gastric VaricesGastrointestinal HemorrhageLiver CirrhosisPortasystemic Shunt, Transjugular IntrahepaticVaricose VeinsHumansRetrospective StudiesSeverity of Illness IndexTreatment OutcomeAcute kidney injuryEarly TIPSHepatic encephalopathyHydrothoraxLiver failurePre-emptive TIPSRefractory ascitesRescue TIPSUpper GI bleeding

Identifiers

PMID34324168
OpenAlexW3185514029

What OpenQuestion holds

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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.