医学
阿卡克信息准则
肝性脑病
肌萎缩
逐步回归
经颈静脉肝内门体分流术
内科学
逻辑回归
门体分流术
脂肪组织
生物电阻抗分析
皮下脂肪组织
体质指数
门脉高压
统计
肝硬化
数学
作者
Wenfeng Shi,Weiguo Xu,Ningning Fan,Yong Li,Xiaoqiong Chen,Yujie Zhao,Xiao Bai,Yang Yang
标识
DOI:10.1097/mcg.0000000000002014
摘要
Background: The relationship between body composition and the risk of overt hepatic encephalopathy (OHE) following transjugular intrahepatic portosystemic shunt (TIPS) needs to be investigated. Methods: Overall, 571 patients from 5 medical centers were included. To assess body compositions, we evaluated skeletal muscle indices, adipose tissue indices, sarcopenia, and myosteatosis at the third lumbar vertebral level. Univariate and Multivariate logistic regression analyses were performed to identify independent risk factors for post-TIPS OHE. An integrated score was then constructed using stepwise multiple regression analyses, with a cut-off value selected using the best Youden index. Finally, the Akaike information criterion (AIC) was performed to compare the integrated score and independent risk factors on their ability in predicting post-TIPS OHE. Results: Sarcopenia and all skeletal muscle indices had limited associations with post-TIPS OHE. The index of the subcutaneous adipose tissue (SATI) ( P =0.005; OR: 1.034, 95% CI: 1.010–1.058) and myosteatosis (297 cases, 52.01%, 125 with OHE, 42.09%; P =0.003; OR: 1.973; 95% CI: 1.262–3.084) were both ascertained as independent risk factors for post-TIPS OHE. The integrated score (Score ALL =1.5760 + 0.0107 * SATI + 0.8579 * myosteatosis) was established with a cutoff value of −0.935. The akaike information criterion (AIC) of Score ALL , SATI, and myosteatosis was 655.28, 691.18, and 686.60, respectively. Conclusions: SATI and myosteatosis are independent risk factors for post-TIPS OHE. However, the integrated score was more significantly associated with post-TIPS OHE than other skeletal muscle and adipose tissue factors.
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