Evidence map›Paper›PMID 40495002›Full record

ArticleDigestive diseases and sciences2025

In-Hospital Outcomes of Patients with Hepatorenal Syndrome Who Underwent Transjugular Intrahepatic Portosystemic Shunt Procedure.

Renxi Li, SeungEun Lee, Peter C Caldwell, Katherine L Tsavaris, Shawn N Sarin

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Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Renxi LiThe George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA. renxili@gwu.edu.ORCID http://orcid.org/0000-0003-1691-6278
SeungEun LeeThe George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Peter C CaldwellDepartment of Medicine, The George Washington University Hospital, Washington, DC, USA.
Katherine L TsavarisDepartment of Medicine, The George Washington University Hospital, Washington, DC, USA.
Shawn N SarinDepartment of Interventional Radiology, The George Washington University Hospital, Washington, DC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatorenal syndrome (HRS) is a severe complication of cirrhosis associated with poor survival. The use of transjugular intrahepatic portosystemic shunt (TIPS) as a therapeutic or bridging therapy for HRS patients remains debated due to its potential severe early complications. This study aimed to retrospectively compare the in-hospital outcomes of HRS patients who received TIPS with those who did not, using a large-scale, population-based national database.

methodsThis study identified patients with HRS in National/Nationwide Inpatient Sample (NIS) database from Q4 2015-2021. A 1:3 propensity-score matching was used to match demographics, socioeconomic status, primary payer status, hospital characteristics, clinical presentations, APR-DRG mortality class, etiology of cirrhosis, and comorbidities between TIPS and non-TIPS cohorts. In-hospital outcomes were compared.

resultsThe NIS database identified 55,545 HRS patients, where 479 patients underwent TIPS. African American patients and those in rural or smaller hospitals were significantly less likely to receive TIPS. Following propensity-score matching, 1,441 HRS patients who did not undergo TIPS were matched to all patients who underwent the procedure. In-hospital mortality (22.59% vs 24.36%, p = 0.46), hepatic encephalopathy (37.87% vs 35.95%, p = 0.48), and liver transplantation rates (7.11% vs 8.26%, p = 0.50) were comparable between patients who underwent TIPS and those who did not. However, patients who underwent TIPS had a longer length of stay (p < 0.01) and higher total hospital charges (p < 0.01) but had a lower transfer-out rate (p < 0.01).

conclusionTIPS does not appear to negatively impact immediate outcomes and could be considered as a potentially therapeutic treatment option for suitable candidates, considering its long-term benefits. Future studies should focus on the long-term prognosis of patients who received TIPS and the potential role of TIPS as a bridging therapy to liver transplantation. Moreover, there could be potential racial and institutional disparities in accessing/offering TIPS that may warrant further investigation.

Indexed as

Hepatorenal SyndromePortasystemic Shunt, Transjugular IntrahepaticAdultAgedDatabases, FactualFemaleHospital MortalityHumansLiver CirrhosisMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeUnited StatesCirrhosisHepatorenal syndromeMortalityPortal hypertensionTransjugular intrahepatic portosystemic shunt

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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.