title: Observational cohort study of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS).
abstract: Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this study was to compare two groups of patients who did and did not develop overt HE after TIPS. We looked for differences between these groups before TIPS.
  
  
  
  A study of 895 patients was conducted based on a retrospective analysis of clinical data. Data was analyzed using Fisher's exact test, Chi-square, Mann Whitney test, unpaired t-test and logistic regression. After the initial analyses, we have looked at a regression models for the factors associated with development of HE after TIPS.
  
  
  
  257 (37.9%) patients developed HE after TIPS. Patients' age, pre-TIPS portal venous pressure, serum creatinine, aspartate transaminase, albumin, presence of diabetes mellitus and etiology of portal hypertension were statistically significantly associated with the occurrence of HE after TIPS (p < 0.01). However, only the age, pre-TIPS portal venous pressure, serum creatinine, presence of diabetes mellitus and etiology of portal hypertension contributed to the regression model. Patients age, serum creatinine, presence of diabetes mellitus and portal vein pressure formed the model describing development of HE after TIPS for a subgroup of patients with refractory ascites.
  
  
  
  we have identified, using a substantial sample, several factors associated with the development of HE after TIPS. This could be helpful in further research.
authors.affiliation: School of Psychiatry, Health Education Wessex, United Kingdom.
authors.forename: Michaela
authors.initials: M
authors.lastname: Routhu
authors.affiliation: Department of Physiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Safka
authors.affiliation: School of Psychiatry, Health Education West Midlands, United Kingdom.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Routhu
authors.affiliation: Department of Internal Medicine, University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Fejfar
authors.affiliation: Department of Internal Medicine, University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Jirkovsky
authors.affiliation: Department of Radiology, University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Antonin
authors.initials: A
authors.lastname: Krajina
authors.affiliation: Computer Technology Center, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Cermakova
authors.affiliation: Department of Psychiatry, University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Hosak
authors.affiliation: Department of Psychiatry, University Hospital in Hradec Kralove, Czech Republic.|Department of Psychiatry, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Czech Republic
authors.forename: Petr
authors.initials: P
authors.lastname: Hulek
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D018153:Czech Republic; D048909:Diabetes Complications / Q000209:etiology; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014690:Venous Pressure; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine