Sarcopenia is a risk factor for post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy and mortality: A systematic review and meta-analysis.

Liver encephalopathy Meta-analysis Muscle atrophy Muscle wasting Portocaval shunt Refractory ascites Sarcopenia Systematic review TIPS Transjugular intrahepatic portacaval shunt Transjugular intrahepatic portosystemic shunt Variceal bleeding

Journal

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
ISSN: 0975-0711
Titre abrégé: Indian J Gastroenterol
Pays: India
ID NLM: 8409436

Informations de publication

Date de publication:
12 Dec 2023
Historique:
received: 13 05 2023
accepted: 24 09 2023
medline: 12 12 2023
pubmed: 12 12 2023
entrez: 12 12 2023
Statut: aheadofprint

Résumé

Transjugular intrahepatic portosystemic shunt (TIPS) is a commonly performed procedure in patients with liver cirrhosis to treat portal hypertension-related conditions, including variceal bleeding and refractory ascites. However, while the increased risk of hepatic encephalopathy (HE) after TIPS is important to consider when determining whether a patient is a good candidate for TIPS, currently there is no widely used method to predict the development of post-TIPS HE, although the model for end-stage liver disease (MELD) score is used to predict post-TIPS mortality. We conducted a systematic review and meta-analysis to evaluate sarcopenia as a risk factor for HE and mortality in patients undergoing TIPS. A comprehensive search strategy was used to identify reports of post-TIPS HE and mortality in sarcopenia vs. non-sarcopenia patients with liver cirrhosis who received TIPS in March 2023. Open Meta Analyst was used to compute the results. Twelve studies with 2056 patients met inclusion criteria and were included in the final meta-analysis. Sarcopenia was associated with a significantly higher post-TIPS HE rate than non-sarcopenia (risk ratio [RR]: 1.68, 95% CI: 1.48-1.92, p < 0.00001, I Patients with sarcopenia have a significantly increased risk of post-TIPS HE and mortality. Presence of sarcopenia should be considered when weighing the risks and benefits of performing TIPS in patients with cirrhosis. Further studies are needed to determine the clinical utility of important risk factors such as sarcopenia on post-TIPS outcomes.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Transjugular intrahepatic portosystemic shunt (TIPS) is a commonly performed procedure in patients with liver cirrhosis to treat portal hypertension-related conditions, including variceal bleeding and refractory ascites. However, while the increased risk of hepatic encephalopathy (HE) after TIPS is important to consider when determining whether a patient is a good candidate for TIPS, currently there is no widely used method to predict the development of post-TIPS HE, although the model for end-stage liver disease (MELD) score is used to predict post-TIPS mortality. We conducted a systematic review and meta-analysis to evaluate sarcopenia as a risk factor for HE and mortality in patients undergoing TIPS.
METHODS METHODS
A comprehensive search strategy was used to identify reports of post-TIPS HE and mortality in sarcopenia vs. non-sarcopenia patients with liver cirrhosis who received TIPS in March 2023. Open Meta Analyst was used to compute the results.
RESULTS RESULTS
Twelve studies with 2056 patients met inclusion criteria and were included in the final meta-analysis. Sarcopenia was associated with a significantly higher post-TIPS HE rate than non-sarcopenia (risk ratio [RR]: 1.68, 95% CI: 1.48-1.92, p < 0.00001, I
CONCLUSION CONCLUSIONS
Patients with sarcopenia have a significantly increased risk of post-TIPS HE and mortality. Presence of sarcopenia should be considered when weighing the risks and benefits of performing TIPS in patients with cirrhosis. Further studies are needed to determine the clinical utility of important risk factors such as sarcopenia on post-TIPS outcomes.

Identifiants

DOI: 10.1007/s12664-023-01465-2 PMID: 38085501
pubmed: 38085501
doi: 10.1007/s12664-023-01465-2
pii: 10.1007/s12664-023-01465-2
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. Indian Society of Gastroenterology.

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Auteurs

Zohaib Ahmed (Z)

Department of Internal Medicine, University of Toledo, Toledo, OH, USA.

Joyce Badal (J)

University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Manesh Kumar Gangwani (MK)

Department of Internal Medicine, University of Toledo, Toledo, OH, USA. Gangwani.manesh@gmail.com.
ORCID: 0000-0002-3931-6163

Ahmad Nawaz (A)

Department of Internal Medicine, Yale-New Haven Hospital, New Haven, CT, USA.

Bryan Badal (B)

Department of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, VA, USA.

Syeda Faiza Arif (SF)

Dow University of Health Sciences, Karachi, Pakistan.

Umer Farooq (U)

Department of Internal Medicine, Loyola Medicine/MacNeal Hospital, Chicago, IL, USA.

Faisal Kamal (F)

Department of Gastroenterology, University of California, Los Angeles, Los Angeles, CA, USA.

Toseef Javaid (T)

Department of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.

Muhammad Aziz (M)

Department of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.

Wade Lee-Smith (W)

University of Toledo Libraries, University of Toledo, Toledo, OH, USA.

Asif Mahmood (A)

Department of Internal Medicine, University of Toledo, Toledo, OH, USA.

Nooraldin Merza (N)

Department of Internal Medicine, University of Toledo, Toledo, OH, USA.

Abdallah Kobeissy (A)

Department of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.

Ali Nawras (A)

Department of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.

Mona Hassan (M)

Department of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.

Classifications MeSH