Improvement of quality of life after TIPS insertion

Background and aims Hydropic decompensation and/or bleeding episodes in liver cirrhosis lead to a significant reduction in the quality of life (QOL). Transjugular intrahepatic portosystemic shunt (TIPS) improves clinical outcome. We aimed to investigate the impact of TIPS insertion on QOL in a homogeneous single-center cohort.

Methods Liver cirrhosis patients who underwent TIPS insertion between January 2018 until December 2020 were studied. Patients who died, got transplanted or were lost to follow-up during the first three months after TIPS intervention were excluded. The SF-36 questionnaire was filled prior to-, 3- and 12- months post-intervention in 77 patients.

Results The majority of patients was male (63 %), median age was 57 years. Baseline Child-Turcotte-Pugh (CTP) stage was A in 16 %, B in 72 % and C in 12 %. Main indication for TIPS was refractory ascites (81 %). Liver transplant-free survival was 90 % and 73 % at months 3 and 12, respectively. At baseline, seven out of eight SF-36 scales were lower than the population mean of 50 %. After TIPS intervention, a significant increase in mean QOL (more than 10 points) was observed in all dimensions [Fig. 1]. The physical (PCS) and mental (MCS) summary measures improved over the time accordingly (mean PCS 27 vs 40 % and mean MCS 39 vs 46 % prior-to (BL) and 12-months (M12) after TIPS). Overall, the summary score showed no improvement or a worsening only in 5 and in 10 patients for PCS and MCS accordingly. The most significant improvement in physical scores was noted in Child-Pugh B patients, while mental scores showed a more pronounced increase in Child-Pugh C patients.

Conclusion As an established therapy for portal hypertension complications, TIPS insertion leads not only to an increased liver transplant-free survival but also to an improvement in all scales of QOL. However, physical scores showed only a minor improvement in advanced stage of liver cirrhosis.

Abb 1. SF-36 scales for BL and M12

Publication History

Article published online:
07 September 2021