年龄较大和TIPS相关住院后的住院时间之间的关联
Matthew Schliep1, Brian J Wentworth1, Indira Bhavsar-Burke2
1Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Canadian journal of gastroenterology & hepatology
|May 29, 2025
概括
年龄不是跨内肝移植系统分流 (TIPS) 插入的严格禁忌. 选择的老年患者可以安全地接受TIPS,其治疗结果与年轻患者在住院治疗方面的结果相似.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 干预性放射学 干预性放射学
- 老年医学 老年医学
背景情况:
- 门高血压并发症随着肝病的进展而增加.
- 跨内肝移植系统 (TIPS) 插入可以治疗许多门高血压并发症.
- 患者年龄对TIPS结果的影响仍在争论中.
研究的目的:
- 评估TIPS插入后年龄对结果的影响.
- 为了比较TIPS相关的并发症和70岁以下和70岁以上患者的住院病例.
- 在TIPS后12个月内确定肝脏相关住院的预测因素.
主要方法:
- 追溯的,双中心的队列研究.
- 包括在2006年至2016年期间接受TIPS治疗的593名患者.
- 主要结局:预测12个月内肝脏相关住院的预测因素,比较年龄组 (<70与≥70).
主要成果:
- 在老年 (≥70) 和非老年 (<70) 患者之间12个月后TIPS并发症入院没有显著差异 (29.2%对29.0%,p=0.91).
- 预测12个月入院的预测因素包括先前存在的糖尿病/高血压,肝脏水胸,以及基线血清肌/.
- 12个月的死亡率和90天的MELD-Na得分是次要结果.
结论:
- 跨内肝移植系统分流 (TIPS) 放置可以在选择的老年患者中安全.
- 年龄本身不应该是TIPS的绝对禁忌.
- 对于考虑TIPS的老年患者来说,对风险和益处的个性化讨论至关重要.
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