Comparison of clinical outcomes of transjugular intrahepatic portosystemic shunt for refractory ascites and recurrent nonrefractory ascites

Table 1 Baseline characteristics of the four groups of patients

Characteristics	Group A, n = 183	Group B, n = 217	Group C, n = 328	Group D, n = 135
Gender, male/female	106/77	137/80	173/155	74/61
Age (year)	53.57 ± 11.62	51.27 ± 13.29	49.24 ± 10.34	51.15 ± 9.25
Child-Pugh A/B/C	13/114/56	0/69/148	0/221/107	0/18/117
MELD score	9.16 ± 3.46	10.37 ± 2.71	11.15 ± 1.41	11.27 ± 1.05
Viral hepatitis	135	162	272	112
Chronic ethanol consumption	31	34	32	14
Cryptogenic hepatitis	17	21	24	9
Laboratory tests
Alanine transaminase (U/L)	37.14 ± 8.17	41.27 ± 7.43	46.25 ± 11.38	48.36 ± 8.17
Aspartate transaminase (U/L)	43.74 ± 9.36	47.28 ± 8.49	54.16 ± 14.25	57.21 ± 12.04
Alkaline phosphatase (U/L)	119.43 ± 17.67	126.27 ± 14.17	124.16 ± 26.18	136.19 ± 21.51
γ-Glutamyl transpeptidase (U/L)	257.43 ± 29.28	262.46 ± 33.45	285.43 ± 27.65	247.32 ± 16.42
Total bilirubin (mol/L)	37.23 ± 6.54	45.13 ± 7.26	49.32 ± 12.17	54.72 ± 09.28
Albumin (g/L)	32.26 ± 2.35	29.14 ± 2.86	27.02 ± 1.54	24.37 ± 2.69
Prothrombin time (second)	15.16 ± 1.46	16.27 ± 1.24	16.18 ± 2.64	17.25 ± 1.31
Clinical presentation
Abdominal distention	167	194	283	103
Abdominal pain	26	38	43	17
Weakness	46	62	189	83
Poor appetite	135	152	315	132
Jaundice	24	37	35	16
Splenomegaly	147	169	317	129
Lower limb edema	132	163	289	116
Ascites paracentesis	176	217	321	135

Baseline characteristics were observed in terms of age, sex, Child-Pugh score, MELD score, laboratory tests and clinical presentation. MELD score: Model of End-Stage Liver Disease score.

Table 2 Outcomes of symptoms in the four groups of patients, n (%)

Symptoms	Group A, n = 183	Group B, n = 217	χ2	P value	Group C, n = 328	Group D, n = 135	χ2	P value
First week of ascites	172 (93.98)	156 (71.88)		0.032	311 (94.81)	82 (60.74)		0.027
Hepatic function compromise	43 (23.49)	146 (67.28)	2.072	0.024	47 (14.32)	96 (71.11)	3.043	0.019
Recurrence of ascites	40 (21.85)	173 (79.72)		0.016	64 (19.51)	119 (88.14)		0.012
Hepatic dysfunction	33 (18.03)	154 (70.96)		0.007	51 (15.54)	107 (79.25)		0.004
Others	7 (3.82)	19 (8.75)		0.025	13 (3.96)	12 (8.88)		0.019
Ascites recurrence times	48	326		0.000	103	202		0.001

The symptoms of ascites in four groups disappeared or were relieved within the first week without paracentesis. The probability of total hepatic impairment and recurrent ascites was significantly different between the groups.

Table 3 Survival rate at 6 months, 1 year, 2 year and 3 years in the four groups of patients

Time	Group	Survival		Survival rate (%)	χ2	P value
		Yes	No
6 months	A	172	11	93.98	5.938	0.007
	B	109	108	50.23
	C	301	27	91.76	6.357	0.006
	D	67	68	49.62
1 year	A	159	24	86.88	5.726	0.003
	B	28	189	12.90
	C	272	56	82.92	6.632	0.002
	D	13	122	9.62
2 years	A	131	52	71.58	8.443	0.002
	B	14	203	6.45
	C	229	99	69.81	9.257	0.001
	D	6	129	4.44
3 years	A	113	70	61.74	8.172	0.002
	B	6	156	2.76
	C	191	137	58.23	8.243	0.001
	D	3	132	2.22

The 6 months, 1-, 2- , and 3-year survival rates differed significantly between group A and B, group C and D.

Table 4 Hepatic encephalopathy occurrence in the four groups of patients

Time	Group	HE occurrence		Occurrence rate (%)	χ2	P value
		Yes	No
1 month	A	25	158	13.66	6.462	0.004
	B	81	136	37.32
	C	69	259	21.03	5.357	0.07
	D	56	79	41.48
3 months	A	38	145	20.76	5.153	0.001
	B	101	116	46.54
	C	76	252	23.17	6.468	0.003
	D	65	70	48.14
6 months	A	30	142	17.44	6.269	0.006
	B	45	64	41.28
	C	57	244	18.93	7.356	0.005
	D	30	37	44.77
1 year	A	19	140	11.94	5.045	0.005
	B	9	19	32.14
	C	43	229	15.80	6.248	0.007
	D	4	9	44.44
2 years	A	12	119	9.16	5.327	0.006
	B	4	10	28.57
	C	25	204	10.91	4.253	0.003
	D	2	4	33.33
3 years	A	7	106	6.19	6.403	0.008
	B	2	4	33.33
	C	13	178	6.80	7.375	0.004
	D	1	2	33.33

HE: Hepatic encephalopathy. There were significant differences in the incidence of hepatic encephalopathy in group A compared with group B, group C compared with group D, at 1, 3, 6, 9 months, 1, 2 and 3 years (P < 0.05).