Clin Mol Hepatol.  2019 Jun;25(2):210-217. 10.3350/cmh.2018.0083.

Portal pressure gradient and serum albumin: A simple combined parameter associated with the appearance of ascites in decompensated cirrhosis treated with transjugular intrahepatic portosystemic shunt

• Zhao D
• Zhang G
• Wang M
• Zhang C
• Li J

• KMID: 2451925
• DOI: http://doi.org/10.3350/cmh.2018.0083

Abstract

BACKGROUND/AIMS
In recent years, greater assessment accuracy after transjugular intrahepatic portosystemic shunt (TIPS) to ascertain prognosis has become important in decompensated cirrhosis due to portal hypertension. The aim of this study was to assess the ratio of the portal pressure gradient (PPG) pre-TIPS (pre-PPG) to albumin (PPA), which influence ascites formation in cirrhotic patients in the 6-months after TIPS placement, and is a metric introduced in our study.
METHODS
This was a retrospective cohort study of 58 patients with decompensated cirrhosis admitted to an academic hospital for the purpose of TIPS placement. We collected the following data: demographics, laboratory measures, and PPG during the TIPS procedure. Then we analyzed the association between the above data and ascites formation post-TIPS in cirrhosis patients.
RESULTS
Twenty-two patients with ascites and 28 without ascites were evaluated. Univariate and binary logistic regression analysis were adjusted for the following variables: to determine prognosis; Child-Pugh scores, lymphocyte count, platelet count, hemoglobin level, albumin level and pre-PPG or PPA. The outcome showed that PPA was better than pre-PPG and albumin for predicting ascites according to area under receiver operating characteristic curves and a statistical model that also showed PPA's influence 6-months post-TIPS.
CONCLUSIONS
The combined measurement of pre-PPG and albumin, defined as PPA, may provide a better way to predict post-TIPS ascites in decompensated cirrhosis, which underlines the need for a large clinical trial in the future.

Keyword

Portal pressure; Serum albumin; Ascites; Portasystemic shunt

MeSH Terms

Ascites*
Cohort Studies
Demography
Fibrosis*
Humans
Hypertension, Portal
Logistic Models
Lymphocyte Count
Models, Statistical
Platelet Count
Portal Pressure*
Portasystemic Shunt, Surgical*
Prognosis
Retrospective Studies
ROC Curve
Serum Albumin*
Serum Albumin