Copyright
©The Author(s) 2023.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1641-1651
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1641
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1641
Table 1 Baseline features of the study population
Characteristic | Before PSM | After PSM | ||||
SPD group | TIPS group | P value | SPD group | TIPS group | P value | |
Age, yr | 44.14 ± 10.64 | 49.57 ± 11.24 | < 0.001 | 46.41 ± 10.81 | 47.16 ± 10.95 | 0.65 |
Male, n (%) | 121 (74.7) | 105 (67.3) | 0.15 | 64 (71.1) | 60 (66.7) | 0.520 |
Bleeding history, mo | 12.70 ± 24.19 | 12.83 ± 21.95 | 0.961 | 13.64 ± 26.76 | 13.6 ± 22.62 | 0.99 |
Spleen length, cm | 20.121 ± 4.49 | 19.27 ± 4.05 | 0.08 | 19.86 ± 4.47 | 18.85 ± 3.57 | 0.10 |
Spleen thickness, cm | 6.47 ± 1.43 | 6.20 ± 1.42 | 0.09 | 6.31 ± 1.29 | 6.05 ± 1.07 | 0.14 |
TB, μmol/L | 22.81 ± 9.93 | 22.18 ± 10.22 | 0.58 | 23.68 ± 10.60 | 21.99 ± 9.65 | 0.26 |
ALT, IU/L | 34.561 ± 27.68 | 32.08 ± 35.49 | 0.49 | 29.81 ± 19.33 | 29.34 ± 15.25 | 0.86 |
AST, IU/L | 40.651 ± 29.05 | 41.218 ± 35.80 | 0.88 | 36.37 ± 22.78 | 37.32 ± 18.09 | 0.76 |
ALB, g/L | 37.71 ± 5.28 | 33.13 ± 6.19 | < 0.001 | 36.35 ± 4.58 | 35.46 ± 5.15 | 0.22 |
A/G | 1.311 ± 0.29 | 1.52 ± 3.40 | 0.45 | 1.31 ± 0.27 | 1.28 ± 0.29 | 0.58 |
ALP, IU/L | 87.10 ± 39.98 | 85.08 ± 52.93 | 0.70 | 86.42 ± 37.50 | 86.93 ± 57.34 | 0.94 |
GGT, IU/L | 50.13 ± 59.94 | 49.26 ± 61.59 | 0.90 | 53.35 ± 71.03 | 49.14 ± 63.91 | 0.68 |
BUN, mmol/L | 6.038 ± 7.87 | 5.89 ± 2.76 | 0.82 | 6.48 ± 10.44 | 5.56 ± 2.00 | 0.42 |
CREA, μmol/L | 72.92 ± 17.01 | 73.02 ± 18.40 | 0.96 | 73.20 ± 18.54 | 69.36 ± 14.59 | 0.13 |
HGB, g/L | 99.74 ± 27.85 | 84.38 ± 23.18 | < 0.001 | 94.42 ± 30.02 | 91.07 ± 23.76 | 0.41 |
RBC, × 1012/L | 3.71 ± 0.82 | 3.06 ± 0.79 | < 0.001 | 3.46 ± 0.81 | 3.39 ± 0.79 | 0.54 |
PLT, × 109/L | 51.85 ± 43.11 | 55.13 ± 37.11 | 0.47 | 50.76 ± 45.62 | 52.86 ± 24.49 | 0.70 |
WBC, × 109/L | 3.68 ± 3.85 | 3.59 ± 3.93 | 0.83 | 3.10 ± 2.56 | 3.38 ± 2.26 | 0.43 |
PT, s | 14.67 ± 3.79 | 14.76 ± 2.08 | 0.79 | 14.38 ± 1.95 | 14.21 ± 1.75 | 0.54 |
INR | 1.27 ± 0.17 | 1.32 ± 0.19 | 0.02 | 1.28 ± 0.17 | 1.27 ± 0.15 | 0.46 |
HBV-DNA Positive | 80 (49.4) | 81 (51.9) | 0.65 | 47 (52.2) | 48 (53.3) | 0.88 |
Child-Pugh classification, n (%) | 0.17 | 1.00 | ||||
A | 89 (54.9) | 75 (48.1) | 49 (54.4) | 49 (54.4) | ||
B | 73 (45.1) | 81 (51.9) | 41 (45.6) | 41 (45.6) | ||
Severe EGV, n (%) | 131 (80.9) | 124 (79.5) | 0.78 | 73 (81.1) | 74 (82.2) | 1.00 |
Table 2 Univariate and multivariate Cox regression analyses of factors associated with death
Variable | Univariable analysis | Multivariable analysis | ||
HR (95%CI) | P value1 | HR (95%CI) | P value | |
Treatment strategy (SPD vs TIPS) | 0.43 (0.24-0.78) | 0.005 | 0.47 (0.25-0.90) | 0.02 |
Age, per 1-year increase | 1.04 (1.02-1.07) | 0.001 | 1.03 (1.01-1.06) | 0.02 |
TB, per 1 μmol/L increase | 1.03 (1.01-1.06) | 0.01 | ||
ALB, per 1 g/L increase | 0.94 (0.91-0.98) | 0.004 | ||
A/G, per 1 increase | 0.06 (0.02-0.18) | < 0.001 | 0.11 (0.03-0.48) | 0.003 |
ALP, per 1 IU/L increase | 1.01 (1.00-1.01) | < 0.001 | ||
GGT, per 1 IU/L increase | 1.003 (1.00-1.01) | 0.03 | ||
PT, per 1 s increase | 1.07 (1.02-1.12) | 0.004 | 1.09 (1.02-1.16) | 0.01 |
INR, per 1 increase | 6.38 (1.68-24.24) | 0.006 | ||
HBV-DNA (Positive vs negative) | 1.78 (1.00-3.15) | 0.05 | ||
Child-Pugh classification (B vs A) | 1.83 (1.07-3.15) | 0.03 |
Table 3 Proportions of 1-, 3-, and 5-year cumulative variceal rebleeding, abnormal liver function, and hepatocellular carcinoma in the two groups before and after propensity score matching, %
Outcome/Time | Before PSM | After PSM | ||||
SPD group | TIPS group | P value1 | SPD group | TIPS group | P value1 | |
Variceal rebleeding | ||||||
1-yr | 8.60 | 20.50 | 0.001 | 7.80 | 11.10 | 0.09 |
3-yr | 19.10 | 34.60 | 15.65 | 27.80 | ||
5-yr | 24.10 | 37.80 | 23.30 | 31.10 | ||
Abnormal liver function | ||||||
1-yr | 13.60 | 48.70 | < 0.001 | 13.30 | 46.70 | < 0.001 |
3-yr | 19.80 | 57.70 | 18.90 | 53.30 | ||
5-yr | 22.80 | 60.30 | 20.00 | 56.70 | ||
Hepatocellular carcinoma | ||||||
1-yr | 2.50 | 3.80 | 0.03 | 2.20 | 4.40 | 0.02 |
3-yr | 3.70 | 9.00 | 2.20 | 10.00 | ||
5-yr | 4.90 | 11.50 | 2.20 | 12.20 |
Table 4 Multivariate Cox regression analysis of factors associated with variceal rebleeding, abnormal liver function, and hepatocellular carcinoma
Outcome/Variable | HR (95%CI) | P value |
Variceal rebleeding | ||
Treatment strategy (SPD vs TIPS) | 0.58 (0.37-0.89) | 0.01 |
GGT, per 1 IU/L increase | 1.005 (1.001-1.008) | 0.01 |
HGB, per 1 g/L increase | 0.99 (0.98-1.00) | 0.01 |
Abnormal liver function | ||
Treatment Strategy (SPD vs TIPS) | 0.26 (0.17-0.39) | < 0.001 |
TB, per 1 μmol/L increase | 1.03 (1.02-1.05) | < 0.001 |
ALP, per 1 IU/L increase | 1.004 (1.000-1.007) | 0.03 |
PT, per 1 s increase | 1.06 (1.00-1.13) | 0.045 |
Hepatocellular carcinoma | ||
Treatment Strategy (SPD vs TIPS) | 0.43 (0.20-0.93) | 0.03 |
TB, per 1 μmol/L increase | 1.03 (1.00-1.07) | 0.045 |
ALP, per 1 IU/L increase | 1.006 (1.000-1.012) | 0.043 |
Table 5 Comparison of postoperative hospital days and number of reoperations and adverse events between the two groups
Variable | SPD group | TIPS group | P value |
Postoperative hospital stay, days | 9.5 ± 3.4 | 6.6 ± 3.9 | < 0.001 |
Reoperation, times | 5 | 92 | < 0.001 |
In-hospital mortality | 1 | 1 | 0.98 |
The 90-d mortality | 1 | 4 | 0.21 |
The 30-d readmission | 1 | 22 | < 0.001 |
Occurrence of hepatic encephalopathy | 1 | 25 | < 0.001 |
- Citation: Qi WL, Wen J, Wen TF, Peng W, Zhang XY, Shen JY, Li X, Li C. Prognosis after splenectomy plus pericardial devascularization vs transjugular intrahepatic portosystemic shunt for esophagogastric variceal bleeding. World J Gastrointest Surg 2023; 15(8): 1641-1651
- URL: https://www.wjgnet.com/1948-9366/full/v15/i8/1641.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v15.i8.1641