Analysis of risk factors of hepatic encephalopathy after TIPS / 重庆医学

ABSTRACT

Objective To investigate the risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) .Methods 181 cases of patients after TIPS diagnosed in this department from January 2009 to December 2013 were reviewed .The patients were divided into two groups42 cases with hepatic encephalopathy (HE group)and 139 cases without he-patic encephalopathy(control group) .To evaluate the possible risk factors such as age ,sex ,pathogeny of cirrhosis ,complications [(Child-Pugh score ,portal pressure gradient (PPG ) ,Child-Pugh grading ,fibrinogen ,hemoglobin ,serum natrium ] were recorded and analyzed .Unconditional logistic regression model(W ald test)was used to screen the independent risk factors .Receiver operating characteristic curve was plotted and the area under it was calculated to evaluate the diagnose performance .Results There was no significant statistical difference between HE group and control group about age ,sex and pathogeny of cirrhosis(P>0 .05) .Analysis of unconditional logistic regression model indicated that Child-Pugh score ,PPG ,Child-Pugh grading ,were single risk factors of HE after operation(OR=1 .29 ,1 .06 ,1 .22) ,while fibrinogen ,hemoglobin and serum natrium were protective factors .ROC curve was plotted and the AUC was calculated to evaluate the diagnose performance ,which indicated the sequence was that ,Child-Pugh score> PPG>Child-Pugh grading>hemoglobin>fibrinogen>serum natrium .Conclusion Child-Pugh score ,PPG ,Child-Pugh grading , fibrinogen ,hemoglobin and serum natrium were single hazard factors of HE after operation .