Hypertension ups risk of rebleeding after TIPSS
Preascites and hypertension are independent risk factors for parent ascites, while hypertension is an independent risk factor for rebleeding following transjugular intrahepatic portosystemic stent shunt (TIPSS) therapy, a new cohort study has found.
Records of 124 patients who received TIPSS were used in the study. Participants were then divided into two groups: elderly (n=37; age ≥60 years; 62.6 percent male) and nonelderly (n=87; age <60 years; 73.6 percent male). Exclusion criteria included unsuccessful and emergency TIPSS treatments.
Propensity score matching was performed between the elderly and nonelderly groups to remove potential confounders. The primary outcome was treatment-related adverse events within 1 year. Total length of stay, postoperative hospital stays and hospital deaths were secondary outcomes.
Multivariate logistic regression revealed that hypertension was a significant independent risk factor for rebleeding (odds ratio [OR], 13.249; 95 percent CI, 1.29 to 136.073; p=0.03).
On the other hand, smoking (OR, 4.48; 1.43 to 14.033; p=0.01) and preascites (OR, 6.7; 2.04 to 22.005; p=0.002) were shown as independent risk factors for patients’ ascites following TIPSS treatment.
There were no significant differences between the elderly and nonelderly groups in terms of therapy-related adverse events such as fever (p=0.266), vomiting (p=0.443), bellyaches (p=0.59), diarrhoea (p=0.151), ascites (p=0.393) and rebleeding (p=0.27), suggesting that age was not a significant risk factor for poor outcomes.
“There are limitations to the present study because of its retrospective design. More patients are needed to match more pairs and increase the credibility of the results,” said researchers.