Predicting disease progression in cirrhotic patients after transjugular intrahepatic portosystemic shunt implantation:A sexstratified analysis
作者机构：Department of RadiologyGuizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510260Guangdong ProvinceChina Department of Infectious DiseasesGuizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina Department of Interventional RadiologyGuizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina Department of Interventional RadiologyThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510260Guangdong ProvinceChina
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2023年第29卷第42期
页 面：5768-5780页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100401[医学-流行病与卫生统计学] 10[医学]
基 金：Supported by the Guizhou Senior Innovative Talent Project No.QKHPTRC-GCC041-1
主 题：Transjugular intrahepatic portosystemic shunt Skeletal muscle index Nutrition Cirrhosis Sex stratified Prognosis
摘 要：BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)has been extensively used to treat portal hypertension-associated complications,including *** prediction of post-TIPS prognosis is important for cirrhotic patients,as more aggressive liver transplantation is needed when the post-TIPS prognosis is *** To construct a nutrition-based model that could predict the disease progression of cirrhotic patients after TIPS implantation in a sex-dependent *** This study retrospectively recruited cirrhotic patients undergoing TIPS implantation for *** quality was assessed by measuring the skeletal muscle index(SMI)by computed *** Cox proportional hazard models were utilized to determine the association between SMI and disease progression in cirrhotic patients after TIPS *** This study eventually included 186 cirrhotic patients receiving TIPS who were followed up for 30.5±18.8 *** male patients,the 30-mo survival rate was significantly lower and the probability of progressive events was higher(3.257-fold)in the low-level SMI group than in the high-level SMI *** to the multivariate Cox analysis of male patients,SMI32.8 was an independent risk factor for long-term adverse outcomes after TIPS implantation.A model was constructed,which involved creatinine,plasma ammonia,SMI,and acute-on-chronic liver failure and hepatic encephalopathy occurring within half a year after *** model had an area under the receiver operating characteristic curve of 0.852,sensitivity of 0.926,and specificity of *** to the results of the DeLong test,this model outperformed other models(Child-Turcotte-Pugh,Model for End-Stage Liver Disease,and Freiburg index of post-TIPS survival)(P0.05).CONCLUSION SMI is strongly associated with poor long-term outcomes in male patients with cirrhosis who underwent TIPS implantation.
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