Prognostic factors of TIPS in treatment of gastroesophageal varices bleeding / 中国介入影像与治疗学

ABSTRACT

Objective: To analyze the prognostic factors of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of esophageal and gastric varices bleeding (EGVB). Methods: A retrospective analysis was performed on 68 patients with EGVB who underwent TIPS. Kaplan-Meier method was used to calculate the cumulative survival after treatment, and the differences of cumulative survival were compared using log-rank test. Multivariate analysis of prognostic factors was carried out with Cox proportional hazards regression model, and ROC curve was used to determine the optimal cut-off value of prognostic factors. Results: The 1-, 2- and 3-year survival rate was 90.7%, 82.2% and 77.9% respectively after TIPS procedures. Cox regression univariate and multivariate analysis showed that the age (P=0.009) and preoperative serum albumin (P=0.024) were independent prognostic factors. The area under the ROC curve of age for assessing whether the survival time more than 1 year was 0.923 (P=0.001), while that of preoperative serum albumin was 0.183 (P=0.011). Patient's age of 67.5 years was the optimal cut-off value. The 1-year cumulative survival rate of patients' aged ≤67.5 years was statistically significant higher than that of those older than 67.5 years (96.4% vs 64.3%, χ2=10.785, P=0.001). Conclusion: Patients' age and preoperative serum albumin are independent predictors for the survival of EGVB after TIPS. Postoperative prognosis of patients' aged >67.5 years is unfavorable.