P93 Transjugular intrahepatic portosystemic stent shunt (TIPPS) procedures in England from 2013 to 2022: investigating the trend of TIPSS procedures amidst rising liver disease admissions in England

<h3>Objectives</h3> The aim of this study was to identify hospital admissions for liver disease in England and to quantify the number of transjugular intrahepatic portosystemic stent shunt (TIPSS) procedures performed from 2013 to 2022. Furthermore, the study investigated potential regional variations and disparities in patient access to TIPSS procedures. <h3>Methods</h3> Patients admitted for a TIPSS procedure were identified from the Hospital Episode Statistics (HES) dataset using procedure (OPCS) codes. Admissions for liver disease were determined from public health data available from the Office for Health Improvement and Disparities. <h3>Results</h3> Hospital admissions for liver disease in England amounted to 56,545 (113.3 per 100,000) in 2013 and increased to 85,665 (155.2 per 100,000) by 2022. The number of TIPSS procedures performed in England was 430 in 2013 and 415 in 2022. <h3>Discussion</h3> This study highlights the year-on-year increase in hospital admissions for liver disease and while the use of TIPSS is a treatment for patients with portal hypertension and its complications such as variceal bleeding and refractory ascites, the number of TIPSS procedures has remained flat over the same period. Notably, there are regional variations in the number of TIPSS procedures. The number of procedures increased in London, whereas in other regions, particularly the Midlands, North West and the North East and Yorkshire, the number of TIPSS procedures decreased despite an increase in hospital admissions for liver disease in these areas. The selection criteria and pathway for a TIPSS procedure are clearly outlined in national guidelines. This study demonstrates potential inequities in patient access to TIPSS across England, which should be investigated at a local level.