Prevalence and influence factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: a Meta-analysis

Objective To systematically evaluate the current status of hepatic encephalopathy (HE) and its influencing factors in patients after transjugular intrahepatic portosystemic shunt (TIPS).Methods Cochrane Library, PubMed, Embase, Web of Science, CINAHL , CNKI, VIP , CBM, WanFang database were searched from inception to October 20, 2024. Meta-analysis was performed using Stata 14.0 and RevMan 5.3 software.Results A total of 40 original studies involving 8,509 patients were included. The results of Meta-analysis showed that the incidence of HE in patients after TIPS was 31%[95%CI(28%, 34%)], and age [OR=1.22, 95%CI(1.15, 1.29)], MELD score [OR=1.46, 95%CI(1.29, 1.65)], preoperative blood creatinine [OR=1.27, 95%CI(1.14, 1.41)], Child-Pugh classification [OR=2.83, 95%CI(1.56, 5.13)], preoperative blood ammonia [OR=1.25, 95%CI(1.18, 1.33)], Child-Pugh score [OR=1.21, 95%CI(1.08, 1.35)], preoperative bilirubin [OR=1.35, 95%CI(1.11, 1.65)], preoperative sodium [OR=1.30, 95%CI(1.16, 1.45)], and a history of preoperative HE [OR=2.00, 95%CI(1.06, 3.76)] were the influence factors for the development of HE in patients after TIPS.Conclusion The incidence of HE in post-TIPS patients is high, and clinicians should identify and intervene early to minimize or delay the occurrence of HE in patients after the TIPS procedure referring to the influence factors.