ArticleThe Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology2023
Post-transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy: Sarcopenia Adds Insult to Injury.
Article in The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses that pooled it.
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9 citing papers in PubMed, 5 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Prevalence and diagnostic variability of sarcopenia in India: A systematic review and meta-analysis.The Indian journal of medical research · 2026Pooled it
- Risk factors for hepatic encephalopathy in patients following transjugular intrahepatic portosystemic shunt: a meta-analysis and systematic review.BMC surgery · 2026Pooled it
- Australian best practice recommendations for transjugular intrahepatic portosystemic shunt (TIPS) in portal hypertension: a consensus statement.Hepatology international · 2026Guideline
- Association between sarcopenia and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: a systematic review and meta-analysis.Abdominal radiology (New York) · 2024Pooled it
- Correlation of ammonia and blood laboratory parameters with hepatic encephalopathy: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Outcomes after TIPS in patients with cirrhosis and sarcopenia: A systematic review and meta-analysis.JHEP reports : innovation in hepatology · 2026Article
- Transjugular intrahepatic portosystemic shunt with ePTFE-covered stentgrafts: incidence and predictors of shunt dysfunction.Insights into imaging · 2025Article
- Bayesian network-based survival prediction model for patients having undergone post-transjugular intrahepatic portosystemic shunt for portal hypertension.World journal of gastroenterology · 2024Article
- Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding.World journal of gastrointestinal surgery · 2024Article
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8 authors at 1 institution in 1 country.
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Abstract
backgroundHepatic encephalopathy, which is a serious complication, and sarcopenia are undesirable consequences in cirrhosis. Transjugular intrahepatic portosystemic shunt increases the risk of hepatic encephalopathy. We investigated the effect of sarcopenia on the incidence of post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy.
methodsClinical data of patients who underwent transjugular intrahepatic portosystemic shunt were extracted retrospectively. Computed tomography images at L3 level of scans performed prior to transjugular intrahepatic portosystemic shunt were analyzed to assess skeletal muscle index-expressed as skeletal muscle area (cm2)/ height (m2).
resultsOf 210 patients who underwent transjugular intrahepatic portosystemic shunt, complete information was available in 79 [male: 68 (86%); age: 50.5 ± 11.2 years; Child-Turcotte-Pugh score: 8.81 ± 1.23; etiology-alcohol: 44 (56%), non-alcoholic steatohepatitis: 16 (20%), others: 19 (24%); transjugular intrahepatic portosystemic shunt indication-ascites: 56 (71%); bleed: 23 (29%); sarcopenics: 42 (53%)]. Post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy developed in 29 (37%) patients. In patients who developed hepatic encephalopathy, both serum ammonia [177.6 ± 82.5 vs. 115.5 ± 40.5 µg/dL, P =.008] and prevalence of sarcopenia [69% vs. 44%; P =.02; odds ratio (95% CI): 2.8 (1.08-7.4), P =.02] were higher, with sarcopenics having 3 times higher risk of hepatic encephalopathy and 8 times higher risk of multiple episode of hepatic encephalopathy [31% vs. 5.4%; odds ratio (95% CI): 8.2 (1.68- 40.5), P =.009]. In multivariate analysis, age [odds ratio (95% CI): 1.05 (1.001-1.11), P =.047], serum albumin [odds ratio (95% CI): 0.162 (0.05-0.56), P =.004], and skeletal muscle index [odds ratio (95% CI): 0.925 (0.89-0.99), P =.017] were independently associated with post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy.
conclusionsSarcopenia is present in nearly half of the cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt, which increases the risk of a single episode of hepatic encephalopathy by 3-fold and that of multiple episodes of hepatic encephalopathy by 8-fold after transjugular intrahepatic portosystemic shunt procedure. Increased skeletal muscle index is associated with decreased risk of hepatic encephalopathy.
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