title: Age-related Morbidity and Mortality After Transjugular Intrahepatic Portosystemic Shunts.
abstract: OBJECTIVE
  To compare age-related morbidity and mortality after transjugular intrahepatic portosystemic shunts (TIPS).
  
  
  METHODS
  We performed a retrospective chart review of patients who underwent TIPS at the University of California Los Angeles Medical Center between 2008 to 2014. Elderly patients (65 y and older) were matched with nonelderly patients (controls, below 65 y) by model for end-stage liver disease (MELD) score (±3), indication for TIPS (refractory ascites vs. variceal bleeding), serum sodium level (±5), in a ratio of 1:1. Endpoints measures were hospital stay post-TIPS, rifaximin, or lactulose use, TIPS failure at 30 days, readmission at 90 days, MELD at 90 days, and mortality at 90 days.
  
  
  RESULTS
  A total of 30 patient matches were included in this study: 30 control and 30 elderly patients. The median [interquartile (IQR)] MELD scores for controls and elderly were 11 (9, 13.8) for the controls and 11.5 (9, 14.8) for elderly patients (P=0.139). There were no significant differences in serum sodium and indication for TIPS. Thirty and 90-day follow-up laboratory test results were also similar between elderly and control patients. Event-free survival at 90 days was similar between controls and elderly patients [odds ratio (OR), 0.86; 95% confidence interval (CI), 0.3-2.5; P>0.05]. There was a trend toward greater hospitalization (OR, 1.76; 95% CI, 0.52-5.95; P=0.546) and mortality (OR, 3.3; 95% CI, 0.3-14.01; P=0.182).
  
  
  CONCLUSIONS
  The results of this study suggest event-free survival is similar between nonelderly and elderly patients. Although statistically significant, there is a tendency toward greater mortality and hospitalization in the elderly.
authors.affiliation: *Department of Medicine, Olive-View Medical Center, Sylmar Departments of †Surgery §Biostatistics ∥Radiology ‡Medicine, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Duminda
authors.initials: D
authors.lastname: Suraweera
authors.forename: Melissa
authors.initials: M
authors.lastname: Jimenez
authors.forename: Matthew
authors.initials: M
authors.lastname: Viramontes
authors.forename: Naadir
authors.initials: N
authors.lastname: Jamal
authors.forename: Jonathan
authors.initials: J
authors.lastname: Grotts
authors.forename: David
authors.initials: D
authors.lastname: Elashoff
authors.forename: Edward W
authors.initials: EW
authors.lastname: Lee
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
mesh_terms: D000367:Age Factors; D000368:Aged; D002140:California; D005260:Female; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome