Muscle fat content correlates with postoperative survival of viral-related cirrhosis patients after the TIPS: a retrospective study

Early prediction of the prognosis of viral-related cirrhosis patients after transjugular intrahepatic portosystemic shunt (TIPS) is beneficial for clinical decision-making. The aim of this study is to explore a comprehensive prognostic assessment model for evaluating the survival outcomes of patients post-TIPS. A total of 155 patients treated with TIPS were included in the study. The data were collected from electronic records. The nutritional status of the patient is evaluated using imaging examinations measuring by the axial CT images from the L3 vertebral level. The primary endpoint was set as death within 1 year after TIPS. Multivariate Cox regression was performed to determine the factors associated with mortality. The Cox regression analysis revealed that the lower PMFI was associated with a lower risk of all-cause mortality after TIPS (hazard ratio [HR] 1.159, 95% confidence interval [CI] 1.063–1.263, <i>p</i> = 0.001). Furthermore, subgroup analyses according to gender revealed the PMFI was associated with postoperative death both in male (HR 2.125, 95% CI, 1.147–3.936, <i>p</i> = 0.017) and female patients (HR 1.070, 95% CI, 1.001–1.144, <i>p</i> = 0.047). The area under the curve (AUC) for predicting death within 1 year was 0.807. The clinical impact curve analysis showed that PMFI had higher levels of risk threshold probability and a smaller gap between actual and predicted curves. In viral-related cirrhosis patients with portal hypertension, increased muscle fat content might be a potential prognostic marker and associated with postoperative death after TIPS. Early prediction of post-TIPS patient survival is currently a clinical challenge.The absolute muscle fat content is correlated with post-TIPS survival time.The muscle fat infiltration can be used as a new evaluation method. The absolute muscle fat content is correlated with post-TIPS survival time. The muscle fat infiltration can be used as a new evaluation method.