Longitudinal Inpatient Trajectories After Splenic Artery Embolization in Cirrhosis: Real-World Evidence from...

Background: Splenic artery embolization (SAE) is commonly used in cirrhosis to manage hypersplenism and cytopenia. However, its longer-term clinical impact beyond hematologic parameters remains insufficiently characterized. Aim: To characterize longitudinal inpatient trajectories, clinical patterns, and follow-up features after SAE in patients with cirrhosis treated at a tertiary referral center in Kazakhstan. Methods: This retrospective single-center study included 149 patients with cirrhosis who underwent SAE. Clinical, laboratory, and imaging data were collected across sequential inpatient episodes. Outcomes included longitudinal patterns of hospitalization, laboratory trends, and baseline factors associated with a favorable clinical course. Subsequent hospitalization was defined as any inpatient episode following the index SAE admission, regardless of whether it was planned or unplanned. Results: During follow-up, 59.1% of patients had a second inpatient episode, with progressively fewer patients contributing to later observations. Liver disease severity remained largely stable, with no significant changes in Child-Pugh distribution. Portal hypertension manifestations, including varices and splenomegaly, remained highly prevalent, while recurrent variceal bleeding was relatively uncommon. Laboratory parameters demonstrated modest changes without sustained statistically significant improvement, and the number of recorded inpatient episodes decreased across sequential follow-up. Relatively stable documented follow-up trajectories were more frequently observed in patients with preserved liver function (Child-Pugh A), absence of ascites, and higher albumin levels. The most common causes of subsequent hospitalization were ascites and hepatic decompensation (38.9%) and varices without bleeding (26.2%), while documented major procedure-related complications were infrequent. Conclusions: In this retrospective single-center cohort, predominantly coil-based proximal or selective SAE demonstrated an acceptable documented major complication profile in selected patients with cirrhosis and portal hypertension. Because no untreated control group was available, the findings should be interpreted as descriptive real-world longitudinal data rather than causal evidence of reduced hospitalization burden.