Transjugular intrahepatic portosystemic shunt for acute variceal bleeding in patients with viral liver cirrhosis: predictors of early mortality.
OBJECTIVE
The purpose of our study was to assess the predictors of early mortality after the creation of transjugular intrahepatic portosystemic shunts (TIPS) for acute variceal bleeding in patients with viral liver cirrhosis.


METHODS
Seventy-three patients (56 men and 17 women; mean age, 51.3 years) with viral liver cirrhosis who underwent TIPS placement for acute variceal bleeding were studied. Multiple covariates, including demographic, clinical, and biochemical parameters, were included in univariate and multivariate analyses to determine their association with early (30-day) mortality.


RESULTS
During the follow-up period (mean, 35 months 3 days), shunt dysfunction occurred in 33 patients (45.2%). Forty-three patients (58.9%) died, and 23 patients (31.5%) died within 30 days of TIPS. Early death was predicted independently by hyperbilirubinemia (> 3 mg/dL; p = 0.004; odds ratio, 10.6) and elevated serum creatinine level (> 1.7 mg/dL; p =0.018; odds ratio, 12.0).


CONCLUSIONS
Hyperbilirubinemia and elevated serum creatinine level are predictive of early mortality after TIPS creation for acute variceal bleeding in patients with viral liver cirrhosis.
Yoon
Chang Jin
CJ
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, 28 Yongon-Dong, Chongno-Gu, Seoul 110-774, South Korea. chungjw@radcom.snu.ac.kr
Chung
Jin Wook
JW
Park
Jae Hyung
JH
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000401:mortality*; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D012709:Serum Albumin; D003404:Creatinine; D001663:Bilirubin