Hepatosplenic Volumes and Portal Pressure Gradient Identify One-year Further Decompensation Risk Post-transjugular...

Area of Science:

• Hepatology
• Interventional Radiology
• Medical Imaging

Background:

• Further decompensation in cirrhosis significantly increases mortality.
• Predictive tools for post-transjugular intrahepatic portosystemic shunt (TIPS) decompensation are limited.
• Cirrhosis patients undergoing TIPS require better risk stratification.

Purpose of the Study:

• To determine the incidence and risk factors for decompensation within one year after TIPS.
• To develop and validate a predictive model for identifying high-risk individuals post-TIPS.
• To improve patient outcomes through targeted interventions.

Main Methods:

• Retrospective cohort study of 152 cirrhosis patients undergoing TIPS.
• Utilized LASSO regression and multivariable logistic analysis to identify predictors.
• Constructed and internally validated a nomogram using bootstrapping.

Main Results:

• 65.8% of patients were stable one year post-TIPS; 34.2% experienced decompensation.
• Key predictors identified: right hepatic lobe volume, spleen volume, and portal pressure gradient (PPG) reduction.
• The developed nomogram showed superior discrimination (AUC 0.854) compared to existing scores.

Conclusions:

• A validated model combining hepatosplenic volumetry and PPG reduction accurately stratifies decompensation risk post-TIPS.
• This model can guide targeted surveillance and preventive strategies for high-risk patients.
• The findings offer a novel approach to managing cirrhosis patients post-TIPS.