ArticleMetabolic brain disease2024
Value of systemic inflammation markers for the detection of minimal and prediction of overt hepatic encephalopathy after TIPS insertion.
Article in Metabolic brain disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The qEEG-TIPS score: Development of a predictive model for recurrent overt hepatic encephalopathy after elective TIPS.JHEP reports : innovation in hepatology · 2026Article
- [Research advances on hepatic encephalopathy following transjugular intrahepatic portosystemic shunt].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Mechanistic insights into the liver-brain axis during chronic liver disease.Nature reviews. Gastroenterology & hepatology · 2026Review
- Management of hepatic encephalopathy following transjugular intrahepatic portosystemic shunts: Current strategies and future directions.World journal of gastroenterology · 2025Review
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Authors and funding
12 authors.
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Abstract
Development of overt hepatic encephalopathy (oHE) is a particularly feared complication when considering treatment with transjugular intrahepatic portosystemic shunt (TIPS). However, the pathophysiology of HE, in particular after TIPS-insertion, is complex and valid predictors remain scarce. We aimed to investigate whether systemic inflammation markers (SIM) are linked to minimal (mHE) and overt HE (oHE) development before and after TIPS. 62 prospectively recruited patients undergoing TIPS-insertion were included and monitored for oHE occurrence two years thereafter. Patients underwent psychometric testing including the portosystemic encephalopathy syndrome test (PSE), yielding the psychometric hepatic encephalopathy score (PHES), and Animal Naming Test (ANT) before TIPS (baseline) and during structured follow-up 1, 3, 6 and 12 months afterwards. SIM (IL-6, TNF-α and IL-1β) were measured at corresponding timepoints. Patients were predominantly male (64.5%) with a median age of 58 years and MELD of 11. The majority (75.8%) received a TIPS for treatment of refractory ascites. 67.9% presented with mHE before TIPS. No link between the investigated SIM and PHES or ANT at baseline or during any follow-up was documented. 19 (30.6%) patients developed oHE during follow-up. Neither baseline SIM levels nor test results were significantly associated with risk for oHE. We demonstrated a significant decline of all SIM during follow-up, which did not translate to an ameliorated risk for oHE. In patients undergoing TIPS-insertion, the selected SIM have neither a strong link to post-TIPS-oHE development nor to subclinical changes in psychometric tests for mHE.
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