Sarcopenia in patients receiving TIPS is independently associated with increased risk of complications and mortality.

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Digestive and Liver Disease Pub Date : 2024-10-28 DOI:10.1016/j.dld.2024.10.013

Emma Vanderschueren, Philippe Meersseman, Alexander Wilmer, Vincent Vandecaveye, Evelyne Dubois, Anne Van Eldere, Jan Clerick, Jo P Peluso, Eveline Claus, Lawrence Bonne, Chris Verslype, Geert Maleux, Wim Laleman

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Abstract

Background: Sarcopenia is an acknowledged risk factor for individuals with chronic liver disease, however, the influence on outcomes in patients receiving transjugular intrahepatic portosystemic shunt (TIPS) remains underexplored.

Aims: This study aimed to investigate the association between sarcopenia and incidence of complications and mortality post-TIPS.

Methods: A retrospective analysis was performed on 175 patients who underwent TIPS between 2011-2021 at a Belgian tertiary care center. Transverse psoas muscle thickness (TPMT) was measured at baseline, with a subset of 85 patients having a second TPMT after 1-2 years for assessment of evolution.

Results: Over a median follow-up of 453 days (IQR 76-1179), sarcopenic patients exhibited a higher prevalence of complications (74.1% vs. 57.9%, p = 0.04) and one-year mortality (53.4% vs. 22.3%, p < 0.001) post-TIPS. Notably, 58.8% of patients showed an increase >10% from baseline TPMT/length post-TIPS, with the greatest improvement observed in severely sarcopenic patients (4.00 ± 4.55 mm/m vs. -0.82 ± 2.68 mm/m, p < 0.001) and in those patients free from TIPS-related complications (3.18 ± 4.09 mm/m vs. 1.31 ± 3.21 mm/m, p = 0.022).

Conclusion: Sarcopenia increases the risk of complications and mortality post-TIPS. Importantly, sarcopenia improves in patients receiving TIPS, particularly in those with severe sarcopenia at baseline and free of TIPS-related complications.

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接受 TIPS 治疗的患者中的肌少症与并发症和死亡风险的增加密切相关。

背景：目的：本研究旨在探讨肌肉疏松症与经颈静脉肝内门体系统分流术（TIPS）后并发症发生率和死亡率之间的关系：研究对比利时一家三级医疗中心在 2011-2021 年间接受 TIPS 的 175 名患者进行了回顾性分析。在基线时测量了腰横肌厚度（TPMT），其中 85 名患者在 1-2 年后进行了第二次 TPMT 测量，以评估演变情况：在中位随访 453 天（IQR 76-1179）期间，肌无力患者在 TIPS 术后的并发症发生率（74.1% 对 57.9%，P = 0.04）和一年死亡率（53.4% 对 22.3%，P < 0.001）均较高。值得注意的是，58.8%的患者在TIPS术后的TPMT/长度比基线增加了10%以上，严重肌少症患者（4.00 ± 4.55 mm/m vs. -0.82 ± 2.68 mm/m，p < 0.001）和无TIPS相关并发症的患者（3.18 ± 4.09 mm/m vs. 1.31 ± 3.21 mm/m，p = 0.022）的改善幅度最大：结论：肌肉疏松症会增加 TIPS 术后并发症和死亡率的风险。重要的是，肌肉疏松症在接受 TIPS 的患者中会得到改善，尤其是那些基线时患有严重肌肉疏松症且未出现 TIPS 相关并发症的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.