Effect of portal pressure gradient reduction on outcomes after transjugular intrahepatic portosystemic shunt in portal hypertension patients

doi:10.4254/wjh.v17.i3.103261

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Hepatol. Mar 27, 2025; 17(3): 103261
Published online Mar 27, 2025. doi: 10.4254/wjh.v17.i3.103261

Table 1 Univariate and multivariate Cox regression analyses for recurrent variceal bleeding before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Group B	0.546	0.366-0.815	0.003^b	0.623	0.387-1.004	0.052	0.520	0.330-0.818	0.005^b	0.520	0.330-0.818	0.005^b
Kalium	0.305	0.120-0.774	0.012^a	0.305	0.119-0.783	0.014^a
Cancer antigen 153	0.691	0.493-0.968	0.032^a	0.713	0.500-1.016	0.061
Creatinine	1.952	1.123-3.394	0.018^a	1.679	0.943-2.990	0.078
Pre-TIPS inferior vena cava pressure	1.629	1.010-2.628	0.046^a	1.556	0.950-2.547	0.079
Pre-TIPS Child-Turcotte-Pugh score	2.513	1.095-5.766	0.030^a	1.983	0.841-4.679	0.118
Portal vein diameter	2.487	1.216-5.084	0.013^a	1.279	0.548-2.984	0.569
Alkaline phosphatase	0.680	0.460-1.006	0.054
Alanine aminotransferase	0.774	0.563-1.065	0.116

^aP < 0.05.

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching; TIPS: Transjugular intrahepatic portosystemic shunt.

Table 2 Univariate and multivariate Cox regression analyses for shunt dysfunction before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Group B	0.372	0.233-0.594	< 0.001^b	0.452	0.261-0.783	0.005^b	0.482	0.297-0.783	0.003^b	0.496	0.305-0.807	0.005^b
Alkaline phosphatase	0.538	0.349-0.830	0.005^b	0.545	0.350-0.849	0.007^b	0.615	0.394-0.958	0.031^a	0.64	0.411-0.998	0.049^a
Kalium	0.338	0.117-0.974	0.045^a	0.302	0.099-0.922	0.035^a
Portal vein diameter	4.075	1.885-8.808	< 0.001^b	1.663	0.656-4.214	0.284
C-Reactive protein	0.926	0.854-1.004	0.062
Serum urea nitrogen	0.69	0.422-1.128	0.139
Right hepatic vein free pressure	1.535	0.846-2.786	0.159
Natrium	0.699	0.412-1.187	0.185
Age	1.549	0.671-3.577	0.305

^aP < 0.05.

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching.

Table 3 Univariate and multivariate Cox regression analyses for hepatic encephalopathy before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Portal vein diameter	0.309	0.193-0.494	< 0.001^b	0.309	0.193-0.494	< 0.001^b	0.299	0.179-0.500	< 0.001^b	0.372	0.204-0.676	0.001^b
Group B							1.672	1.260-2.219	< 0.001^b	1.263	0.909-1.755	0.163

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching.

Table 4 Univariate and multivariate Cox regression analyses for hepatocellular carcinoma before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Group B	0.332	0.154-0.713	0.005^b	0.37	0.171-0.800	0.012^a	0.346	0.149-0.802	0.013^a	0.374	0.160-0.874	0.023^a
Creatinine	3.098	1.406-6.828	0.005^b	2.144	0.868-5.297	0.098	3.091	1.434-6.662	0.004^b	3.253	1.442-7.340	0.004^b
Prothrombin time activity	0.593	0.293-1.201	0.147				0.178	0.039-0.813	0.026^a	0.128	0.026-0.623	0.011^a
Pre-TIPS MELD score	58.775	1.249-2766.772	0.038^a	13.367	0.160-1115.608	0.251
Female	0.422	0.163-1.093	0.075
Alanine aminotransferase	0.63	0.377-1.053	0.078
Pre-TIPS inferior vena cava pressure	0.579	0.281-1.193	0.139
White blood cell count	0.635	0.337-1.194	0.159
Chlorine	26.688	0.261-2726.917	0.164
Blood ammonia	0.737	0.390-1.393	0.348
C-reactive protein	1.058	0.931-1.203	0.387
Hemoglobin	1.59	0.402-6.288	0.508

^aP < 0.05.

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching; TIPS: Transjugular intrahepatic portosystemic shunt; MELD: Model for end-stage liver disease.

Table 5 Univariate and multivariate Cox regression analyses for liver failure before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Group B	2.166	1.288-3.643	0.004^b	2.523	1.486-4.283	0.001^b	2.238	1.284-3.901	0.005^b	2.241	1.276-3.937	0.005^b
Creatinine	2.802	1.536-5.110	0.001^b	3.096	1.702-5.630	< 0.001^b	2.529	1.287-4.970	0.007^b	3.12	1.500-6.486	0.002^b
Right hepatic venous wedge pressure	2.614	1.223-5.586	0.013^a	2.643	1.229-5.680	0.013^a	1.941	0.858-4.392	0.112
Alanine aminotransferase	1.45	0.979-2.146	0.064				1.683	1.091-2.598	0.019^a	1.541	1.003-2.366	0.048^a
Cancer antigen 153	0.727	0.484-1.092	0.124				0.814	0.511-1.299	0.389
Platelet count	1.265	0.893-1.794	0.186				1.261	0.855-1.859	0.242
Carcinoembryonic antigen	0.877	0.639-1.202	0.414				0.852	0.597-1.218	0.38
C-Reactive protein							1.166	1.049-1.296	0.004^b	1.138	1.022-1.267	0.019^a
Alkaline phosphatase							1.461	0.909-2.348	0.117
Pre-TIPS right atrial pressure							1.595	0.882-2.884	0.123
International normalized ratio							0.283	0.044-1.845	0.187
Blood ammonia							0.704	0.440-1.129	0.145
Pre-TIPS MELD score							0.6	0.024-14.884	0.755
Activated partial thromboplastin time							2.952	0.880-9.905	0.08
Hemoglobin							2.551	0.903-7.205	0.077

^aP < 0.05.

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching; TIPS: Transjugular intrahepatic portosystemic shunt; MELD: Model for end-stage liver disease.

Table 6 Univariate and multivariate Cox regression analyses for mortality before and after propensity score matching

Characteristics	Before PSM, univariate analyses (n = 815)			Before PSM, multivariate analyses (n = 815)			After PSM, univariate analyses (n = 662)			After PSM, univariate analyses (n = 662)
Characteristics	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95%CI	P
Group B	0.491	0.301-0.801	0.004^b	0.507	0.309-0.832	0.007^b	0.549	0.323-0.933	0.027^a	0.550	0.322-0.940	0.029^a
C-reactive protein	1.217	1.104-1.342	< 0.001^b	1.218	1.103-1.344	< 0.001^b	1.213	1.095-1.344	< 0.001^b	1.213	1.094-1.345	< 0.001^b
Creatinine	2.974	1.687-5.243	< 0.001^b	2.652	1.419-4.956	0.002^b	2.548	1.375-4.721	0.003^b	2.349	1.198-4.606	0.013^a
Right hepatic venous wedge pressure	2.514	1.187-5.322	0.016^a	1.819	0.845-3.916	0.126	2.194	1.008-4.772	0.048^a	1.687	0.759-3.749	0.199
Glutamyl transferase	1.231	0.961-1.577	0.100				1.297	0.999-1.683	0.051
Portal vein diameter	0.642	0.271-1.521	0.314				0.488	0.196-1.214	0.123

^aP < 0.05.

^bP < 0.01.

HR: hazard ratio; PSM: Propensity score matching.

Citation: Wang ZB, Zhu B, Meng MM, Wu YF, Zhang Y, Li DZ, Tian H, Wang FC, Lv YF, Ye QX, Liu FQ. Effect of portal pressure gradient reduction on outcomes after transjugular intrahepatic portosystemic shunt in portal hypertension patients. World J Hepatol 2025; 17(3): 103261
URL: https://www.wjgnet.com/1948-5182/full/v17/i3/103261.htm
DOI: https://dx.doi.org/10.4254/wjh.v17.i3.103261