Risk Factors Analysis Of Overt Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt

Objective:Investigate OHE incidence and risk factors with Viatorr stent to enable early assessment,prevention,and intervention.Methods: The Second Hospital of Hebei Medical University conducted a retrospective study with 185 cirrhotic portal hypertension patients who had TIPS with a Viatorr stent from Jan 2018-Dec 2022.Exclusions included patients with missing data(n=39)and lost to follow-up(n=28).Patients were divided into two groups based on OHE during follow-up: OHE and non-OHE.General clinical data were analyzed using SPSS 26.0.Univariate analysis identified potential hepatic encephalopathy factors with P<0.05,included in multivariable logistic regression analysis to predict OHE.Results: 1.A total of 185 patients were included,including 137 males and 48 females;The average age is(54.27 ± 14.21)years;Among them,hepatitis B cirrhosis accounted for 61.1% of all causes;28 patients developed overt hepatic encephalopathy(OHE)within 3 months after surgery,with an incidence rate of 15.1%(28/185).Among them,grade 2 HE accounted for 64.2%(18/28),grade 3 32.1%(9/28),and grade 4 3.6%(1/28);37 cases of OHE occurred within 1 year after surgery,with an incidence rate of 20.1%(37/185).Among them,grade 2 HE accounted for 56.7%(21/37),grade 3 37.8%(14/37),and grade 4 5.4%(2/37).2.Univariate analysis between groups: the age,history of hepatic encephalopathy,Child-Pugh C level,Alb,Cr level,proportion of patients with moderate/massive ascites,and proportion of patients with SBP in the OHE group were higher than those in the non-OHE group.Statistically significant(P<0.05).3.Multivariate Logistic regression analysis showed that the independent risk factors for OHE after TIPS were advanced age(>65 years old),moderate/massive ascites,and Child-Pugh C grade.4.There was no significantdifference in the 1-year survival rate between the OHE group and the non-OHE group(95.7% vs.93.8%,P=0.063)Conclusions:1.In this study,15.1% of patients experienced OHE 3 months or less following TIPS.The incidence of OHE within 1 year was 20.1%.2.Age,ascites,previous history of hepatic encephalopathy,Child-Pugh C,SBP,Alb,and Cr levels were linked with OHE following TIPS,according to a univariate analysis.3.Multivariable logistic regression analysis revealed that advanced age,Child-Pugh C and moderate/large ascites were independent risk factors for early postoperative OHE after TIPS.Early intervention is recommended for high-risk patients to improve outcomes.4.There was no significant difference in 1-year survival between OHE and OHE patients.