Older age is associated with increased early mortality after transjugular intrahepatic portosystemic shunt
Título del documento: Older age is associated with increased early mortality after transjugular intrahepatic portosystemic shunt
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000409081
ISSN: 1665-2681
Autores: 1
2
1
2
1
2
Instituciones: 1Washington University, Mallinckrodt Institute of Radiology, Saint Louis, Missouri. Estados Unidos de América
2Washington University, School of Medicine, Saint Louis, Missouri. Estados Unidos de América
Año:
Volumen: 15
Número: 2
Paginación: 215-221
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Aplicado, descriptivo
Resumen en inglés The role of age as a predictor of mortality after transjugular intra hepatic portosystemic shunt (TIPS) is controversial. Age has been found to be an important predictor of post-TIPS mortality in some, but not all, studies and is not a component of the MELD score. The purpose of this study was to compare the 90-day survival of subjects with cirrhosis age ≥ 70 years with younger subjects undergoing TIPS. Material and methods. Material and methods. A Material and methods. database of adult with cirrhosis undergoing TIPS from 2003- 2011 was analyzed. The primary endpoint was survival 90-days post-TIPS. Survival was analyzed by the Kaplan-Meier method and proportional hazard modeling. Results. Results. 539 Results. subjects met study criteria. 474 (88%) were between the ages of 24-69 and 65 (12%) were age 70-89 years. The groups were similar with respect to the indication for TIPS, mean MELD score and distribution of MELD score. Survival 90-days post-TIPS was 60% in the older cohort compared with 85% in the younger cohort (p < 0.001). Proportional hazards modeling controlled for comorbidities identified age ≥ 70 and MELD score as predictors of early post-TIPS survival. The hazard ratio associated with age increased monotonically, became significant at age ≥ 70 years (HR 3.22; 95% CI 1.81-5.74; p < 0.001) and exceeded the effect of MELD on survival. Age ≥ 70 was associated with reduced survival within 90 days following TIPS. The findings from this study indicate that age is a relevant consideration in assessing the early mortality risk of TIPS
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Sistema cardiovascular,
Cirrosis hepática,
Hipertensión portal,
Derivación intrahepática portosistémica transyugular,
Ancianos,
Sobrevivencia
Keyword: Medicine,
Cardiovascular system,
Gastroenterology,
Liver cirrhosis,
Portal hypertension,
Transjugular intrahepatic portosystemic shunt,
Aged,
Survival
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