Hepatic encephalopathy due to TIPS--retrospective study

Abstract

Background/aims: The main problem of transjugular intrahepatic portosystemic shunt is high incidence of hepatic encephalopathy (HE). The aim of our retrospective study was to determine the incidence the risk factors of clinically significant encephalopathy.

Methodology: 430 patients with liver cirrhosis treated by TIPS in Faculty Hospital in Hradec Králové, Czech Republic.

Results: Incidence of HE was 35.8%. Patients with HE were older (57.7 +/- 12.1 years) than patients without HE (50 +/- 1.4 years) (p < 0.001). HE developed in 28.6% in patients with ethylic etiology and in 43.9% in patients with non-ethylic etiology (p < 0.001). In diabetic patients HE developed in 51.6% (47 of 111), as compared with 30.5% (44 of 319) in non-diabetic patients (p < 0.01). We did not observe a difference in the incidence of HE in relation to sex, stage of cirrhosis, diameter of the stent nor the drop of the portosystemic gradient. Multivariance analysis revealed however to be statistically significantly conditioned by age and not by the presence of diabetes or etiology of liver cirrhosis.

Conclusions: The risk factors for HE in our patients were older age, other than ethylic etiology of liver cirrhosis and diabetes mellitus. There was no direct relationship between the development of HE and other investigated parameters.