Sarcopenia as a Risk Factor in Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt (TIPS) Implantation

Sarcopenia as a Risk Factor in Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt (TIPS) Implantation

<b>Background</b>: Prior studies suggest that patients’ body composition changes following transjugular intrahepatic portosystemic shunt (TIPS) implantation, potentially influencing complications and survival. <b>Method</b>: A prototype artificial intelligence (AI)-based, aut...

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Main Authors: Laura Büttner, Annette Aigner, Regina Stegherr, Simon Iseke, Martin Jonczyk, Willie Magnus Lüdemann, Timo Alexander Auer, Federico Collettini, Dirk Schnapauff, Maximilian de Bucourt, Bernhard Gebauer, Dominik Geisel, Georg Böning
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
Subjects:
body composition
computed tomography
transjugular intrahepatic portosystemic shunt
sarcopenia
Online Access:https://www.mdpi.com/2075-4418/15/11/1440
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Summary:<b>Background</b>: Prior studies suggest that patients’ body composition changes following transjugular intrahepatic portosystemic shunt (TIPS) implantation, potentially influencing complications and survival. <b>Method</b>: A prototype artificial intelligence (AI)-based, automated computed tomography (CT) body composition analysis tool was used to assess body composition imaging parameters in pre- and postinterventional scans of TIPS patients: visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA), and total abdominal muscle area (TAMA). Sarcopenia was defined as a lumbar skeletal muscle index (LSMI) ≤ 38.5 cm<sup>2</sup>/m<sup>2</sup> in women and ≤52.4 cm<sup>2</sup>/m<sup>2</sup> in men. We analyzed longitudinal changes in body composition and investigated the impact of sarcopenia at TIPS implantation on the risk of TIPS thrombosis, hepatic encephalopathy, complications, and death using Cox regression models. <b>Results</b>: No clear trend emerged regarding changes in body composition parameters during postinterventional follow-up. Sarcopenia at TIPS implantation increased the instantaneous risk of postinterventional complications (hazard ratio (HR) 1.67; 95% confidence interval (CI) 0.95–2.93), development of hepatic encephalopathy (HR 1.65; 0.81–3.33), as well as the risk of dying within one year (HR 1.39; 0.66–2.92). <b>Conclusions</b>: CT body composition analysis may help in identifying high-risk patients undergoing TIPS implantation. Sarcopenia was associated with increased mortality and a higher incidence of postinterventional complications, particularly hepatic encephalopathy.
ISSN:2075-4418

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