Impact of Malnutrition on Outcomes in Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt Insertion
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ORIGINAL ARTICLE
Impact of Malnutrition on Outcomes in Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt Insertion Ryan S. Chiang1 · Alice Parish2 · Donna Niedzwiecki2,5 · Matthew R. Kappus3 · Andrew J. Muir3,4 Received: 11 September 2019 / Accepted: 30 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Malnutrition is common in patients with cirrhosis and is associated with poor outcomes after hepatic resection and liver transplantation. Transjugular intrahepatic portosystemic shunt (TIPS) is performed for complications of cirrhosis. Aim To assess the impact of malnutrition on TIPS outcomes. Methods A retrospective analysis was performed using the Healthcare Cost and Utilization Project: National Inpatient Sample database for TIPS procedures from 2005 to 2014. The primary end point was in-hospital mortality. The association of specific malnutrition diagnostic codes and race–ethnicity on mortality was evaluated with survey-weighted logistic regression adjusted for age, gender, admission type, insurance payer, hospital region, comorbidities, and length of stay (LOS). Results From 2005 to 2014, an estimated 53,207 (95% CI 49,330–57,085) admissions with TIPS occurred. A diagnosis of malnutrition was present in 11%. In-hospital death post-TIPS occurred in 15.0% versus 10.7% (p value
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