Your browser doesn't support javascript.
loading
Use and outcome of TIPS in hospitalized patients in Germany: A Nationwide study (2007-2018).
Gu, Wenyi; Zeleke, Yasmin; Hortlik, Hannah; Schaaf, Louisa; Uschner, Frank E; Schulz, Martin; Tischendorf, Michael; Peiffer, Kai-Henrik; Brol, Maximilian Joseph; Kimmann, Markus; Vogl, Thomas; Köhler, Michael; Meyer, Carsten; Gerbes, Alexander; Rössle, Martin; Laleman, Wim; Zipprich, Alexander; Steib, Christian; Praktiknjo, Michael; Trebicka, Jonel.
Afiliación
  • Gu W; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Zeleke Y; Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
  • Hortlik H; Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
  • Schaaf L; Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
  • Uschner FE; Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
  • Schulz M; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Tischendorf M; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Peiffer KH; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Brol MJ; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Kimmann M; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Vogl T; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Köhler M; Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
  • Meyer C; Clinic for Radiology, University Hospital Muenster, Muenster, Germany.
  • Gerbes A; Clinic for Radiology, University Hospital Bonn, Bonn, Germany.
  • Rössle M; Department of Medicine II, University Clinic Munich LMU, Munich, Germany.
  • Laleman W; Department of Internal Medicine II, Faculty of Medicine, Medical Centre University of Freiburg, University of Freiburg, Freiburg, Germany.
  • Zipprich A; Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
  • Steib C; Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
  • Praktiknjo M; Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
  • Trebicka J; Department of Medicine II, University Clinic Munich LMU, Munich, Germany.
Hepatol Commun ; 7(10)2023 10 01.
Article en En | MEDLINE | ID: mdl-37708430
BACKGROUND: The number of complications in patients admitted for cirrhosis has increased over time. Portal hypertension is the driver of many complications of cirrhosis. TIPS placement is the most effective treatment of portal hypertension. The aim of this study was to analyze the use and impact of TIPS placement in the last decade in a nationwide study in Germany. METHODS: We analyzed 14,598 admissions of patients for TIPS insertions in Germany from 2007 to 2018 using the DRG system, 12,877 out of 2,000,765 total admissions of patients with cirrhosis. All diagnoses and procedures were coded according to ICD-10-CM and OPS codes. The data were analyzed, focusing on the number of admissions and in-hospital mortality. RESULTS: The number of TIPS placements increased over the last decade. In-hospital mortality of cirrhotic patients with TIPS decreased when it was placed for severe bleeding (15.2% [TIPS] vs. 19.5% [endoscopy treatment]), ascites (8.7% [TIPS] vs. 14.4% [paracentesis]), and hepatorenal syndrome (HRS) (17.1% [TIPS] vs. 43.3% [no-TIPS]). In the case of bleeding, TIPS significantly decreased in-hospital mortality and also in ascites and HRS. During hospitalization, 22.6% admissions of patients with TIPS insertion showed HE. However, in-hospital mortality in patients admitted with HE grades 1 or 2 and TIPS was lower than in patients without TIPS. In the logistic regression, a higher HE grade(3 and 4), infection, and circulatory disease were found to be independently associated with in-hospital mortality in patients with TIPS insertion. CONCLUSION: Our nationwide study demonstrates that TIPS insertion is increasingly used in Germany. TIPS improves outcomes, especially in patients with ascites and HRS, regardless of lower HE grades, while higher HE grades, infection, and circulatory diseases seem to be associated with risk of in-hospital mortality.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Hipertensión Portal Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Hepatol Commun Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Hipertensión Portal Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Hepatol Commun Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos