Autores: Gaba Ron C, Lakhoo Janesh
Background and rationale for the study: There is currently no definition of post-transjugular intrahepatic portosystemic shunt (TIPS) liver failure (PTLF), which constitutes a barrier to standardization of TIPS results reporting and limits the ability to compare liver failure incidence across clinical studies. This descriptive study proposes and preliminarily tests the performance of a PTLF definition and grading system. Results: PTLF was defined by > 3-fold bilirubin and/or > 2-fold INR elevation associated with clinical outcomes of prolonged hospitalization/increase in care level (grade 1), TIPS reduction or liver transplantation (grade 2), or death (grade 3) within 30-days of TIPS. PTLF incidence was 20% (grades 1, 2, 3: 10%, 3%, 8%) among 270 TIPS cases, and the scheme identified patients at increased risk for morbidity and mortality with a statistically significant difference in clinical outcomes between PTLF and non-PTLF groups (P<0.0001). Conclusions: In conclusion, the PTLF definition and classification scheme put forth distributes patients into unique risk groups. PTLF grading may thus be useful for standardization of TIPS results reporting.
Palabras clave: Hepatic insufficiency classification portosystemic shunting.
2016-06-23 | 138 visitas | Evalua este artículo 0 valoraciones
Vol. 15 Núm.2. Marzo-Abril 2016 Pags. 230-235 Ann Hepatol 2016; 15(2)