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Researchers find older age associated with decreased survival post-TIPS

Elderly adults older than 70 years with cirrhosis had reduced survival 90 days post-transjugular intrahepatic portosystemic shunt, according to published findings.

“Understanding the risks and benefits of [transjugular intrahepatic portosystemic shunt] in older individuals has its merits because it is reasonable to expect that an aging population will also be reflected in increasing numbers of older patients with liver disease related complications. … [We sought to determine] the outcome of [transjugular intrahepatic portosystemic shunt] in cirrhotic subjects 70 years of age and older compared with younger patients,” Kevin M. Korenblat, MD, associate professor, internal medicine, Washington University School of Medicine, St. Louis, MO, and colleagues wrote.

In a single-center cohort study, the researchers evaluated data of 539 patients with cirrhosis who underwent successful transjugular intrahepatic portosystemic shunt (TIPS) between January 2003 and July 2011. Ninety-day survival rates and other factors of older patients (aged 70 years and older; n = 65) were compared with outcomes of younger patients (between 24 and 69 years of age; n = 474). The younger and older groups were similar for indications for TIPS, mean MELD score and distribution of MELD score.

Overall, survival rate 90 days post-TIPS was lower in the older cohort (60%) compared with the younger cohort (85%; P < .001). Proportional hazards modeling analyses showed age and MELD score as independent predictors of post-TIPS survival. The hazard ratio (HR) associated with age increased monotonically and became significant at age 70 years (HR = 3.22; 95% CI 1.81-5.74). The HR also exceeded the effect of MELD on survival, according to the research.

The researchers concluded: “The findings from this study indicate that age is a relevant consideration in assessing the early mortality risk of TIPS.” – by Melinda Stevens

Disclosure: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.