Transjugular intrahepatic portosystemic shunt (TIPS) placement: A comparison of outcomes between patients with hepatic hydrothorax and patients with refractory ascites

S. Young, J. Bermudez, L. Zhang, N. Rostambeigi, J. Golzarian

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Purpose: To compare the outcomes in patients who had transjugular intrahepatic portosystemic shunts (TIPS) placed for hepatic hydrothorax with those who had it placed for refractory ascites. Materials and methods: One hundred and forty-seven patients who underwent TIPS placement for refractory fluid accumulation were included. There were 97 men and 50 women with a mean age of 56.1 ± 9.7 (SD) years (range: 25–81 years). Of those, 32 patients (32/147; 21.8%) had refractory hepatic hydrothorax and 115 (115/147; 78.2%) had refractory ascites. Electronic medical records were reviewed for all patients to determine demographic, procedural related, and outcomes data. Both traditional analysis and a propensity score matching analysis were performed, to account for differences in baseline laboratory values, etiology of cirrhosis, age, and average number of paracenteses/thoracenteses per week. Survival analysis was also performed to compare post-TIPS survival by indication. Results: Differences in response rates, in terms of fluid accumulation reductions, at 1, 3, and 6 months were not significant (P = 0.19, P = 0.33, and P = 0.28, respectively). A successful propensity score matching was made between 24 hepatic hydrothorax and 46 ascites patients. After propensity score matching the response rates at 1, 3, and 6 months remained non-significant (P = 0.3, P = 0.71, and P = 0.78 respectively). No differences in mean overall survival were found between hepatic hydrothorax patients (672 days) and ascites patients (1224 days) (P = 0.15). Conclusion: The clinically relevant outcomes of improvement in fluid accumulation and overall survival do not appear to be significantly different in patients who have TIPS placed for refractory hepatic hydrothorax or and those who have TIPS placed for ascites.

Original languageEnglish (US)
Pages (from-to)303-308
Number of pages6
JournalDiagnostic and Interventional Imaging
Volume100
Issue number5
DOIs
StatePublished - May 2019

Bibliographical note

Funding Information:
Statistical support was provided by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2018 Société française de radiologie

Keywords

  • Hydrothorax
  • Interventional radiology
  • Outcome study
  • Propensity score
  • Transjugular intrahepatic portosystemic shunt (TIPS)

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