Early post-TIPS hyperbilirubinemia predicts mortality in cirrhosis

Early hyperbilirubinemia (total bilirubin ≥5 mg/dL within 1 week) after transjugular intrahepatic portosystemic shunt (TIPS) occurred in 4.8% of cirrhotic patients and independently predicted mortality (1-year 37.3% vs 7.7%; adjusted subdistribution hazard ratio 3.03).

• Retrospective single-center study of 1,404 cirrhotic patients who underwent TIPS; early post-TIPS hyperbilirubinemia was defined as total bilirubin ≥5 mg/dL within 1 week.
• Multivariate Fine-Gray modeling identified early hyperbilirubinemia (sHR 3.03), age, albumin, MELD score, and hepatocellular carcinoma as independent mortality predictors.
• Change in total bilirubin (ΔTB) was also independently associated with mortality (continuous sHR 1.19; dichotomized at ≥2.98 mg/dL sHR 2.64).

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