Impact of Frailty on the Prognosis of Patients With Liver Cirrhosis Undergoing Insertion of a TIPS
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View abstract on PubMed
Summary
This summary is machine-generated.Transjugular intrahepatic portosystemic shunt (TIPS) insertion may improve physical function in frail cirrhosis patients. Pre-TIPS frailty assessment identifies patients with excellent prognosis, but frailty is not a contraindication for TIPS.
Area Of Science
- Hepatology
- Transplant Surgery
- Geriatrics
Background
- Frailty negatively impacts prognosis in liver transplant candidates.
- Limited data exists on frailty's impact post-transjugular intrahepatic portosystemic shunt (TIPS) and TIPS' effect on longitudinal frailty changes in cirrhosis patients.
Purpose Of The Study
- To evaluate the impact of frailty on prognosis after TIPS insertion in cirrhosis patients.
- To assess the influence of TIPS on longitudinal changes in frailty.
Main Methods
- Retrospective analysis of 123 prospectively recruited cirrhosis patients undergoing elective TIPS.
- Assessment of Liver Frailty Index (LFI) pre-TIPS and at 1, 3, and 6 months post-TIPS.
- Monitoring for death, liver transplantation, or post-TIPS overt hepatic encephalopathy (OHE).
Main Results
- 53% of initially frail patients improved to prefrail status within 6 months post-TIPS.
- Higher LFI and younger age correlated with LFI decrease.
- No significant association between LFI and OHE or transplant/death, but lowest LFI quartile showed better transplantation-free survival.
Conclusions
- TIPS may enhance physical functioning in patients with pre-TIPS frailty.
- Pre-TIPS LFI identifies patients with excellent prognosis.
- Frailty should not preclude TIPS candidacy.
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