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Sarcopenia in patients receiving TIPS is independently associated with increased risk of complications and mortality
Emma Vanderschueren1, Philippe Meersseman2, Alexander Wilmer2
1Department of Gastroenterology and Hepatology, University Hospital Leuven, Herestraat 49, Leuven, Belgium; Department of Chronic Diseases, Metabolism and Aging (CHROMETA), Catholic University of Leuven, Herestraat 49, Leuven, Belgium.
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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