Risk factors contributing to early infection following transjugular intrahepatic portosystemic shunt in perioperative period.

UNLABELLED: Introducción and aim. To investigate and identify the risk factors associated with early infection following a transjugular intrahepatic portosystemic shunt (TIPS)procedure in perioperative period.

MATERIAL AND

METHODS

The interventional radiology database at the West China Hospital in Sichuan, China was reviewed to identify all patients that underwent a TIPS procedure between January 30, 2013 and August 30, 2015. Four hundred and sixty-six TIPS patients with liver cirrhosis were enrolled in this study. Liver function was assessed using the Child-Pugh classification system and bacteremia was defined as patients that had a positive blood culture. Statistical analysis was performed using χ2 tests (include Fisher's exact tests χ2) and logistic regression analyses. A P< 0.05 was set as the threshold for statistical significance.

RESULTS

One hundred and forty-eight of the 466 (31.7%) patients developed a fever. Eighty-three of the 148 fever patients subsequently had blood drawn for cultures and 9/83 (10.8%) patients developed bacteremia as defined by a blood culture analysis. Cholangiolithiasis (P = 0.006), Child-Pugh class A designation (P = 0.001), Child-Pugh class C designation (P = 0.005) and hepatitis C virus infection (P = 0.011) were significantly correlated with fever in these patients. No statistically significant correlations were found between the other factors (age, gender, clinical manifestation, diabetes mellitus, cholangiolithiasis, etc.) and bacteremia, with the exception of periprocedure cholangiolithiasis, which was significantly correlated with blood culture-defined bacteremia (P < 0.05).

CONCLUSIONS

Cholangiolithiasis is a risk factor for infection after a TIPS procedure in the periprocedure period.